Anticholinergic

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(Redirected from Anticholinergic toxicity)

 

  • An anticholinergic refers to a substance or medication that blocks the effects of acetylcholine, a neurotransmitter involved in the cholinergic signaling pathway.
  • Anticholinergics inhibit the activity of acetylcholine at cholinergic receptors, thereby modulating various physiological processes in the body.
  • Anticholinergics binds to and blocks nicotinic and/or muscarinic receptors, thereby preventing the actions of the neurotransmitter acetylcholine (Ach) at these receptors.
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Mechanism of Action[edit | edit source]

Anticholinergics exert their effects by binding to and blocking the activation of cholinergic receptors.

These receptors are found throughout the body and are classified into two main types:

  • Muscarinic Receptors: These receptors are located in various organs, including the heart, smooth muscles, and glands. Anticholinergics that target muscarinic receptors are referred to as muscarinic antagonists.
  • Nicotinic Receptors: Nicotinic receptors are found in the central nervous system, autonomic ganglia, and neuromuscular junctions. Anticholinergics that block nicotinic receptors are called nicotinic antagonists.
  • By inhibiting the binding of acetylcholine to these receptors, anticholinergics disrupt the transmission of nerve impulses in cholinergic pathways.

Effects of Anticholinergics[edit | edit source]

The blockade of cholinergic receptors by anticholinergics can result in various physiological and pharmacological effects, including:

  • Decreased Secretions: Anticholinergics can reduce the production of saliva, tears, sweat, and other secretions by inhibiting the activation of cholinergic receptors in the glands.
  • Smooth Muscle Relaxation: Anticholinergics cause relaxation of smooth muscles in the airways, [[gastrointestinal tract], and bladder. This effect can help alleviate symptoms of conditions such as asthma, irritable bowel syndrome, or overactive bladder.
  • Increased Heart Rate: In certain situations, anticholinergics can lead to an increase in heart rate by blocking the inhibitory effects of acetylcholine on the heart's pacemaker cells.
  • Cognitive and Central Nervous System Effects: Anticholinergics can have central nervous system effects, including sedation, confusion, and memory impairment. These effects are more likely to occur with anticholinergics that can penetrate the blood-brain barrier.

Uses of Anticholinergics[edit | edit source]

Anticholinergics find applications in various medical fields:

Examples of Anticholinergics[edit | edit source]

Some examples of anticholinergic medications include:

  • Atropine: Atropine is a classic anticholinergic medication used for various purposes, such as dilating the pupils, reducing salivary and respiratory secretions, and treating certain cardiac conditions.
  • Scopolamine: Scopolamine is commonly used to prevent motion sickness and treat nausea and vomiting.
  • Tiotropium: Tiotropium is an inhaled anticholinergic medication used in the treatment of chronic obstructive pulmonary disease (COPD) to improve airflow.
  • Oxybutynin: Oxybutynin is used to alleviate symptoms of overactive bladder, including urinary frequency, urgency, and incontinence.
  • These are just a few examples of the many anticholinergic medications available, each with its specific uses and considerations.

Adverse Effects[edit | edit source]

The use of anticholinergics may be associated with certain adverse effects, which can include:

  • Dry Mouth and Eyes: Decreased secretions can result in dry mouth and dry eyes, leading to discomfort and increased risk of dental caries or eye irritation.
  • Blurred Vision: Anticholinergics can cause temporary blurred vision due to pupillary dilation and reduced ability to focus on nearby objects.
  • Constipation: Anticholinergics may slow down bowel movements, leading to constipation.
  • Urinary Retention: In some cases, anticholinergics can impair bladder emptying and lead to urinary retention.
  • Central Nervous System Effects: Certain anticholinergics can cross the blood-brain barrier and cause central nervous system side effects, such as drowsiness, confusion, dizziness, or memory problems.

Contraindications and Precautions[edit | edit source]

There are certain situations in which the use of anticholinergics may be contraindicated or require caution.

These include:

  • Glaucoma: Anticholinergics should be used with caution in individuals with narrow-angle glaucoma as they can increase intraocular pressure.
  • Urinary Retention: Anticholinergics are generally contraindicated in individuals with urinary retention, as they can exacerbate the condition.
  • Gastrointestinal Obstruction: Anticholinergics should be avoided in individuals with gastrointestinal obstruction, as they can further impair gastrointestinal motility.
  • Prostate Enlargement: Anticholinergics may worsen urinary symptoms in individuals with prostate enlargement (benign prostatic hyperplasia).
  • Cardiovascular Conditions: Some anticholinergics may have cardiac effects and should be used cautiously in individuals with certain cardiovascular conditions, such as arrhythmias or heart failure.

Drug Interactions[edit | edit source]

  • Anticholinergics may interact with other medications, leading to potential effects or changes in their pharmacological actions.
  • It is important to consider possible drug interactions when prescribing or using anticholinergics, especially in combination with the following:
  • Antidepressants: Anticholinergics can enhance the anticholinergic effects of certain antidepressant medications, potentially increasing the risk of adverse effects.
  • Antihistamines: Concurrent use of antihistamines and anticholinergics can lead to additive anticholinergic effects, resulting in increased side effects such as sedation and dryness.
  • Antipsychotics: Some antipsychotic medications have inherent anticholinergic properties. Combining them with anticholinergics can potentiate anticholinergic effects and increase the risk of side effects.
  • Other Medications: It is important to consider potential interactions with specific medications, such as certain antiparkinsonian drugs, antispasmodics, or medications used to treat urinary incontinence.

See Also[edit | edit source]

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