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anticholinergic effects

Laurine Andre, Adeline Gallini, François Montastruc, Nicola Coley, Jean-Louis Montastruc, Bruno Vellas, Sandrine Andrieu, Virginie Gardette
AIM: To assess the association between anticholinergic (atropinic) burden and cognitive decline in older adults over 3 years. METHODS: We used data from Multidomain Alzheimer Preventive Trial (MAPT) study participants aged ≥70 years and at risk of cognitive decline. Cognitive function was assessed with a composite score (Mini Mental State Examination orientation, Free and Cued Selective Reminding Test, Category Naming Test, Digit Symbol Substitution Test) at 12, 24 and 36 months...
August 10, 2018: British Journal of Clinical Pharmacology
Adrian Wagg
Overactive bladder (OAB) is a common, troublesome condition affecting the lives of many older people. When pharmacotherapy is considered, antimuscarinics remain the mainstay for treatment. Bladder antimuscarinics are effective in the relief of symptoms for OAB and treatment leads to significant improvements in quality of life for those with the condition. However, many older people (> 65 years) with OAB are in later life (> 75 years) and a proportion of these will either be medically complex, with multiple comorbid conditions, or frail...
August 10, 2018: Drugs & Aging
Henry J Woodford
Urinary incontinence (UI) is a common and disabling problem among older people. Anticholinergic drugs (ADs) are a pharmacological option recommended for overactive bladder or mixed UI when non-pharmacological approaches have failed. However, UI is a more prevalent and complex condition in frail older people and to simply assume that AD actions are the same across all age groups would be wrong. This article reviews evidence for the efficacy and safety of these drugs, especially when prescribed for frail older people...
August 10, 2018: Drugs & Aging
Cecilia Lenander, Åsa Bondesson, Nina Viberg, Anders Beckman, Patrik Midlöv
BACKGROUND: Drug use among the elderly population is generally extensive and the use of potentially inappropriate medications (PIMs) is common, which increases the risk for drug-related problems (DRP). Medication reviews are one method to improve drug therapy by identifying, preventing and solving DRPs. The aim of this study was to evaluate the effect of medication reviews on total drug use and potentially inappropriate drug use in elderly patients, as well as describe the occurrence and types of drug-related problems...
August 7, 2018: BMC Health Services Research
H Cho, J Myung, H S Suh, H-Y Kang
Despite their anticholinergic side effects, first-generation antihistamines are widely prescribed to elderly patients. A systematic review was conducted to synthesize real-world evidence. First-generation antihistamine use is considerably associated with an increased risk of injurious falls or fracture among the elderly. INTRODUCTION: First-generation antihistamines are considered potentially inappropriate for elderly patients owing to anticholinergic side effects. We aimed to determine whether elderly patients taking antihistamines are at increased risk of injurious falls or fracture...
July 25, 2018: Osteoporosis International
Niklas Bobrovitz, Carl Heneghan, Igho Onakpoya, Benjamin Fletcher, Dylan Collins, Alice Tompson, Joseph Lee, David Nunan, Rebecca Fisher, Brittney Scott, Jack O'Sullivan, Oliver Van Hecke, Brian D Nicholson, Sarah Stevens, Nia Roberts, Kamal R Mahtani
BACKGROUND: Rates of emergency hospitalisations are increasing in many countries, leading to disruption in the quality of care and increases in cost. Therefore, identifying strategies to reduce emergency admission rates is a key priority. There have been large-scale evidence reviews to address this issue; however, there have been no reviews of medication therapies, which have the potential to reduce the use of emergency health-care services. The objectives of this study were to review systematically the evidence to identify medications that affect emergency hospital admissions and prioritise therapies for quality measurement and improvement...
July 26, 2018: BMC Medicine
Eiji Kose, Toshiyuki Hirai, Toshiichi Seki
AIM: Limited research exists regarding the effect of anticholinergic drugs on fracture in geriatric Japanese patients. The aim of the present study was to establish whether anticholinergic load affects hip fracture and to clarify the risk based on the Anticholinergic Risk Scale score among geriatric patients in a convalescent rehabilitation setting. METHODS: The present nested case-control study included consecutive geriatric patients admitted and discharged from the convalescent rehabilitation ward between 2010 and 2016...
July 25, 2018: Geriatrics & Gerontology International
Gulnar Gondolova, Parham Taslimi, Ajdar Medjidov, Vagif Farzaliyev, Afsun Sujayev, Mansura Huseynova, Onur Şahin, Bahattin Yalçın, Fikret Turkan, İlhami Gulçin
[Ni(C11 H9 N2 O5 )2 (H2 O)2 ]•3(C3 H7 NO) (1) and [Co(C11 H9 N2 O5 )2 (H2 O)2 ]•3(C3 H7 NO) (2) are synthesized and characterized by elemental analysis, FT-IR spectra, magnetic susceptibility, and thermal analysis. In addition, the crystal structure of Ni(II) complex is presented. Both complexes show distorted octahedral geometry. In 1 and 2, metal ions are coordinated by two oxygen atoms of salicylic residue and two nitrogen atoms of maleic amide residue from two ligands, and two oxygen atoms from two water molecules...
July 25, 2018: Journal of Biochemical and Molecular Toxicology
Annie Chen, Brian McIntyre, Elise J B De
PURPOSE OF REVIEW: Pelvic organ prolapse (POP) is a common condition for which approximately 200,000 US women annually undergo surgical repair [Am J Obstet Gynecol 188:108-115, 2003]. After surgical correction, persistent or new lower urinary tract symptoms (LUTS) can be present. We provide guidance on the current tools to predict, counsel, and subsequently handle postoperative LUTS. The current literature is reviewed regarding LUTS diagnosis and management in the setting of prolapse surgery with an emphasis on newer developments in this area...
July 24, 2018: Current Urology Reports
Jonas Höjer, Markus Tellerup
Promethazine is a phenothiazine derivative antihistamine first introduced in the 1940s that is used in multiple medical conditions as a sedative/hypnotic agent. The drug is not addictive, which probably explains why it is increasingly used in the care of drug addicts. During the recent decade the sales of promethazine in Sweden have increased threefold while the yearly number of overdose cases with this drug at the Swedish Poisons Centre has increased from 100 to nearly 700. The anticholinergic delirium that may be provoked by this poisoning carries a symptomatology which may resemble the symptoms seen after an intracranial catastrophe, wherefore some cases are exposed to unnecessary diagnostic measures and invasive ventilator treatment...
July 24, 2018: Läkartidningen
Arschang Valipour, Sherwin Asadi, Christophe Pison, Marie Jondot, Romain Kessler, Khaled Benneddif, Gaetan Deslee, Margaux Verdier, Dirk-Jan Slebos, Martin Mayse
Background: Targeted lung denervation (TLD) is a novel bronchoscopic therapy for COPD which ablates parasympathetic pulmonary nerves running along the outside of the two main bronchi with the intent of inducing permanent bronchodilation. The goal of this study was to evaluate the feasibility and long-term safety of bilateral TLD during a single procedure. Patients and methods: This prospective, multicenter study evaluated 15 patients with moderate-to-severe COPD (forced expiratory volume in 1 s [FEV1 ] 30%-60%) who underwent bilateral TLD treatment following baseline assessment without bronchodilators...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Benoit Peyronnet, Gregory Vurture, Jose-Alberto Palma, Dominique R Malacarne, Andrew Feigin, Rachael D Sussman, Milton C Biagioni, Ricardo Palmerola, Rebecca Gilbert, Nirit Rosenblum, Steven Frucht, Horacio Kaufmann, Victor W Nitti, Benjamin M Brucker
INTRODUCTION: This study aimed to assess the outcomes of mirabegron for the treatment of overactive bladder (OAB) symptoms in patients with Parkinson disease (PD). METHODS: A retrospective study was conducted including patients with PD who received mirabegron 50 mg once daily for OAB symptoms between 2012 and 2017. The primary endpoint was clinical success defined as any improvement in overactive bladder symptoms self-assessed by the patients 6 weeks after mirabegron initiation...
July 20, 2018: Parkinsonism & related Disorders
Mobolaji Adeola, Rejena Azad, Gizat M Kassie, Beverly Shirkey, George Taffet, Michael Liebl, Kathryn Agarwal
Delirium threatens the functional independence and cognitive capacity of patients. Medications, especially those with strong anticholinergic effects, have been implicated as a preventable cause of delirium. We evaluated the effect of multicomponent interventions aimed at reducing the use of 9 target medications in hospitalized older adults at risk of delirium. This continuous quality improvement program was undertaken at a tertiary care facility and 4 community hospitals in a hospital system. We included 21, 541 hospital admissions with patients aged 70 and older on acute care medical or surgical units from the preintervention (2012) period, and 27,764 from the postintervention (2015) period...
July 23, 2018: Journal of the American Geriatrics Society
Helene G van der Meer, Hans Wouters, Lisa G Pont, Katja Taxis
OBJECTIVE: To evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI). DESIGN: Randomised controlled single blind trial. SETTING: 15 community pharmacies in the Northern Netherlands. PARTICIPANTS: 157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1...
July 19, 2018: BMJ Open
Renu Arora, Ritesh Kumar, Amit Agarwal, K H Reeta, Y K Gupta
Centella asiatica (CA) has been used by Ayurvedic medical practitioners in India for almost 3000 years. The neuropharmacological properties of CA and its constituents have been studied extensively. Anti-oxidant, free radical scavenging and cholinergic modulatory activities are the reported mechanisms of action for its efficacy in memory disorders. Its medicinal values are mainly attributed to the presence of several triterpenes, namely asiatic acid, madecassic acid, asiaticoside, and madecassoside. The present study was aimed to investigate the role of these triterpenes content in CA extract on the antioxidant, cholinesterase modulation and anti-amnesic properties...
September 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Misuzu Tajiri, Yutaro Suzuki, Takuro Sugai, Nobuto Tsuneyama, Toshiyuki Someya
It has long been known that antipsychotic drugs (ATP) causes tachycardia, however details such as the differences between ATP are not well known. In recent years, the relationship between the rise in resting heart rate (RHR) and the increased risk of death in the general population has been garnering attention. In this study, we examined the difference in action on RHR between olanzapine (OLZ) and aripiprazole (ARP). The changes in the RHR on switching from OLZ to ARP and on increasing from the starting OLZ dose to the final one were evaluated in 19 outpatients (Study 1) and in 29 outpatients with schizophrenia (Study 2), respectively...
2018: PloS One
Damien Motavasseli, Camille Chesnel, Audrey Charlanes, Diane Menoux, Francis Charoenwong, Frédérique Le Breton, Gérard Amarenco
PURPOSE: To evaluate adherence to anticholinergic therapy (AT) and clean intermittent self-catheterization (CISC) in patients with multiple sclerosis (MS) and to identify factors associated with poor adherence. METHODS: This single-center study prospectively included 49 patients suffering from MS who had been prescribed AT and/or CISC. Adherence was evaluated using a self-report questionnaire. The Expanded Disability Status Scale (EDSS), Patient Global Impression of Improvement, Mini-Mental State Examination, Urinary Symptom Profile, and Hospital Anxiety and Depression (HAD) instruments were administered, and the number of daily anticholinergic pills and/or catheterizations was noted...
June 2018: International Neurourology Journal
Catherine J Byrne, Caroline Walsh, Caitriona Cahir, Cristín Ryan, David J Williams, Kathleen Bennett
OBJECTIVES: The Drug Burden Index (DBI) tool quantifies individual exposure to anticholinergic and sedative medications. The DBI has been internationally validated against adverse health outcomes in older people. DBI exposure has not been reported in the Irish older population. This study aimed to: (1) develop a list of drugs with clinically significant anticholinergic and/or sedative effects (DBI medications) relevant to Ireland; (2) examine, using the DBI formula, the prevalence of exposure to DBI medications in Irish older people and (3) explore patient factors associated DBI exposure...
July 6, 2018: BMJ Open
Zoran Radojicic, Sasa Milivojevic, Natasa Milic, Jelena Milin Lazovic, Marija Lukac, Aleksandar Sretenovic
OBJECTIVE: To examine the effects of bowel management on the frequency of urinary infections in spina bifida patients. STUDY DESIGN: The research was carried out from 2014 to 2017, with the recruitment process from June 2014 to March 2016. The first group consisted of 35 patients who were administered bowel management combined with anticholinergic medication therapy and clean intermittent catheterization (CIC). The second group consisted of 35 patients who were treated only with anticholinergic medication therapy and CIC...
June 30, 2018: Journal of Pediatric Urology
Ali Akkoç, Cemil Aydın, Murat Uçar, Aykut Buğra Şentürk, Murat Topçuoğlu, Ahmet Metin
Introduction: Vesicovaginal fistula (VVF) is a problem that physically and psychologically debilitates the patient. Options for treatment of VVF include transabdominal, transvaginal, transvesical, laparoscopic, and robotic repair or minimally invasive methods such as fulguration. We describe a novel minimally invasive technique: transvesicoscopic bipolar sealing of the vesicovaginal fistula (TBSF). Case Presentation: We carried out the transvesicoscopic sealing of VVF with 5 mm of diameter on a 46-year-old woman, who had a failed conservative treatment with a Foley catheter placement...
2018: Journal of Endourology Case Reports
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