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anticholinergic effects

Niina-Mari Inkeri, Merja Karjalainen, Maija Haanpää, Hannu Kautiainen, Juha Saltevo, Pekka Mäntyselkä, Miia Tiihonen
WHAT IS KNOWN AND OBJECTIVE: Anticholinergic drug use has been associated with a risk of central and peripheral adverse effects. There is a lack of information on anticholinergic drug use in persons with diabetes. The aim of this study is to investigate anticholinergic drug use and the association between anticholinergic drug use and self-reported symptoms in older community-dwelling persons with and without diabetes. METHODS: The basic population was comprised of Finnish community-dwelling primary care patients aged 65 and older...
October 12, 2018: Journal of Clinical Pharmacy and Therapeutics
Niko M Perttila, Hanna Öhman, Timo E Strandberg, Hannu Kautiainen, Minna Raivio, Marja-Liisa Laakkonen, Niina Savikko, Reijo S Tilvis, Kaisu H Pitkälä
INTRODUCTION: No study has investigated how exercise modifies the effect of fall-related drugs (FRDs) on falls among people with Alzheimer's disease (AD). OBJECTIVE: The aim of this study was to investigate how exercise intervention and FRDs interact with fall risk among patients with AD. METHODS: In the FINALEX trial, community-dwelling persons with AD received either home-based or group-based exercise twice weekly for 1 year (n =129); the control group received normal care (n =65)...
October 13, 2018: Drugs & Aging
Afrin Kamal, Mark Pimentel
Up to two-thirds of patients with IBS attribute their gastrointestinal symptoms to food. The therapeutic focus of IBS has been to alleviate gastrointestinal symptoms, approached by pharmaceutical and non-pharmaceutical treatments. Although the most traditional approach has involved the use of medications such as bulking agents, anticholinergics, antispasmodics, and antidiarrheals, unfortunately these are only modestly effective and patients are left with a small menu of successful pharmacologic agents. These treatments, however, are not always enough to alleviate symptoms...
October 12, 2018: American Journal of Gastroenterology
Ai-Leng Foong, Kelly A Grindrod, Tejal Patel, Jamie Kellar
OBJECTIVE: To review the symptoms of serotonin toxicity (commonly referred to as serotonin syndrome ) and the causative drugs and their mechanisms of action, and to equip primary care providers with practical strategies to prevent and identify serotonin toxicity. QUALITY OF EVIDENCE: PubMed and Google Scholar were searched for relevant articles on serotonin toxicity, the causes, and the differential diagnosis using search terms related to serotonin toxicity ( serotonin syndrome, serotonin toxicity, serotonin overdose ), causes (individual names of drug classes, individual drug names), and diagnosis ( differential diagnosis, neuroleptic malignant syndrome, anticholinergic toxicity, discontinuation syndrome, malignant hyperthermia, serotonin symptoms )...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Bharath A Chhabria, Ashish Bhalla, Nusrat Shafiq, Susheel Kumar, Deba Prasad Dhibar, Navneet Sharma
INTRODUCTION: Organophosphate (OP) poisoning is an important public health concern in South-Asia especially in the farming population. Treatment of OP poisoning has remained unchanged since decades and case fatality is 10-40% despite best supportive care, anticholinergic agents and oximes. A new antidote is the need of the hour. Lipid emulsion being inexpensive, easily available and effective in management of other lipid soluble toxins may be a novel option. However, safety has not been established and efficacy is limited to animal studies and case reports in humans with OP poisoning...
October 11, 2018: Clinical Toxicology
Esther Katharina Kiesel, Yvonne Marina Hopf, Michael Drey
BACKGROUND: Anticholinergic drugs put elderly patients at a higher risk for falls, cognitive decline, and delirium as well as peripheral adverse reactions like dry mouth or constipation. Prescribers are often unaware of the drug-based anticholinergic burden (ACB) of their patients. This study aimed to develop an anticholinergic burden score for drugs licensed in Germany to be used by clinicians at prescribing level. METHODS: A systematic literature search in pubmed assessed previously published ACB tools...
October 11, 2018: BMC Geriatrics
Thomas R Porter
In a study, published in this issue of Echo Research and Practice, Ntoskas et al. retrospectively analyzed the safety of a cardiac physiologist performing, and interpreting, Dobutamine stress echocardiography (DSE) in of 300 patients undergoing DSE for the detection of inducible reversible ischemia, myocardial viability and valvular heart disease. While safety during the tests themselves did not appear to be compromised with this unsupervised approach, the interpretation of these DSEs causes concerns regarding broad patient safety relative to misread results...
September 1, 2018: Echo Research and Practice
Jinwoo Kim, Yashwardhan R Malpani, Jooyun Lee, Jin Soo Shin, Soo Bong Han, Young-Sik Jung
First-line medical treatment against nerve agents consists of co-administration of anticholinergic agents and oxime reactivators, which reactivate inhibited AChE. Pralidoxime, a commonly used oxime reactivator, is effective against some nerve agents but not against others; thus, new oxime reactivators are needed. Novel tacrine-pyridinium hybrid reactivators in which 4-pyridinealdoxime derivatives are connected to tacrine moieties by linear carbon chains of different lengths (C2-C7) were prepared (Scheme 1, 5a-f)...
October 4, 2018: Bioorganic & Medicinal Chemistry Letters
Jared S Magee, Luke M Pittman, Leslie A Jette-Kelly
BACKGROUND Asthma is a common disease in the U.S. POPULATION: Initial therapy in the stepwise approach for asthma management is short-acting β₂-agonist (SABA) therapy as needed for symptom control. However, a significant adverse event that can occur with administration is bronchospasm. Here, we report a case of paradoxical bronchospasm with administration of SABAs during multiple pulmonary function tests (PFTs). CASE REPORT A 25-year-old, non-smoking, African American male with a history of moderate asthma and allergic rhinitis treated with fluticasone/salmeterol diskus, albuterol hydrofluoroalkane (HFA) inhaler, and montelukast presented to our clinic complaining of recurrent episodes of acute shortness of breath immediately following each administration of albuterol for 4 weeks...
October 9, 2018: American Journal of Case Reports
Gunel Maharramova, Parham Taslimi, Afsun Sujayev, Vagif Farzaliyev, Lokman Durmaz, İlhami Gulçin
In the presence of trifluoroacetic acid, on the basis of three-component condensation of phenylthiourea with its salicylaldehyde and methyl-3-oxobutanoate, an efficient method for the synthesis of 1-(4-(2-hydroxyphenyl)-6-methyl-1-phenyl-2-thioxo-1,2,3,4-tetrahydropyrimidin-5-yl)ethanone (I) has been worked out. These novel N-substituted tetrahydropyrimidines based on phenylthiourea showed good inhibitory action against acetylcholinesterase (AChE), α-glycosidase, and human carbonic anhydrase (hCA) isoforms I and II...
October 6, 2018: Journal of Biochemical and Molecular Toxicology
Giulia Anzalone, Giusy Daniela Albano, Angela Marina Montalbano, Loredana Riccobono, Anna Bonanno, Rosalia Gagliardo, Fabio Bucchieri, Roberto Marchese, Monica Moscato, Mirella Profita
Thymic stromal lymphopoietin (TSLP) is a cytokine expressed in the epithelium, involved in the pathogenesis of chronic disease. IL-17A regulates airway inflammation, oxidative stress, and reduction of steroid sensitivity in chronic obstructive pulmonary disease (COPD). TSLP and IL-17A were measured in induced sputum supernatants (ISs) from healthy controls (HC), healthy smokers (HS), and COPD patients by enzyme-linked immunosorbent assay. Human bronchial epithelial cell line (16HBE) and normal bronchial epithelial cells were stimulated with rhIL-17A or ISs from COPD patients to evaluate TSLP protein and mRNA expression...
October 5, 2018: Experimental & Molecular Medicine
Kate Madden, Kinza Hussain, Robert C Tasker
OBJECTIVES: It is important to describe and understand the prevalence and risk factors for the syndrome of delirium in critical illness. Since anticholinergic medication may contribute to the development of delirium in the PICU, we have sought to quantify anticholinergic medication exposure in patients with prolonged admission. We have used Anticholinergic Drug Scale scores to quantify the magnitude or extent of this burden. DESIGN: Retrospective cohort study, January 2011 to December 2015...
October 2018: Pediatric Critical Care Medicine
Jana Graf, Rudolf A Jörres, Tanja Lucke, Dennis Nowak, Claus F Vogelmeier, Joachim H Ficker
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is common around the world and carries a high morbidity and mortality. Symptom- and risk-oriented drug treatment is recommended, both in Germany and in other countries. It is not yet known to what extent the treatment that is actually delivered in Germany corresponds to the current recommendations in the guidelines. METHODS: As recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2017, 2281 patients of the national COPD cohort COSYCONET (COPD and Systemic Consequences-Comorbidities Network) were classified into Gold classes A-D on the basis of disease-specific manifestations and the frequency of exacerbations...
September 14, 2018: Deutsches Ärzteblatt International
M Wiciński, B J Kałużny, S Liberski, D Marczak, M Seredyka-Burduk, K Pawlak-Osińska
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are widely used antidepressants with a relatively safe profile. One of the complications associated with this group of drugs is acute angle closure (AAC). The mechanisms linking SNRIs and AAC are complex and may be interlinked with the effects of the drug on the inhibition of serotonin and noradrenaline reuptake, as well as pseudo-anticholinergic effects, dopaminergic effects, and idiosyncratic reactions with the drug molecule in the eye. Individual characteristics, such as polymorphisms of the gene encoding the 2D6 subunit of cytochrome P450, may affect the metabolism of the SNRI; while, the combination with other drugs may lead to an increased risk of iridocorneal angle closure, and may further exacerbate other mechanisms...
September 29, 2018: Survey of Ophthalmology
Leonid Kapulsky, Benjamin D Brody
Urinary retention is a well-documented adverse effect of antipsychotic medications and is thought to be mediated by anticholinergic, adrenergic, and other neurotransmitter effects. Whereas urinary retention has been reported with typical and some atypical antipsychotics, there have been no reports of urinary retention with the novel antipsychotic cariprazine. We report on a case of urinary retention associated with cariprazine. Possible mechanisms for this adverse effect are discussed.
September 28, 2018: Clinical Neuropharmacology
Bettina Balint, Niccolò E Mencacci, Enza Maria Valente, Antonio Pisani, John Rothwell, Joseph Jankovic, Marie Vidailhet, Kailash P Bhatia
Dystonia is a neurological condition characterized by abnormal involuntary movements or postures owing to sustained or intermittent muscle contractions. Dystonia can be the manifesting neurological sign of many disorders, either in isolation (isolated dystonia) or with additional signs (combined dystonia). The main focus of this Primer is forms of isolated dystonia of idiopathic or genetic aetiology. These disorders differ in manifestations and severity but can affect all age groups and lead to substantial disability and impaired quality of life...
September 20, 2018: Nature Reviews. Disease Primers
Aneta Wojdyło, Paulina Nowicka
This study discusses polyphenolic compounds identified and quantified in Actinidia arguta fruits by LC-MS-PDA-Q/TOF method and in vitro anticholinergic activity. Notably, of 31 compounds, including 16 flavonols, 7 flavanols, 7 phenolic acids, and 1 anthocyanin were identified or tentatively identified on the basis of their retention times, accurate mass measurements and subsequent mass fragmentation data, or by comparison with reference substances and literature. Among the detected compounds, 27 were reported for the first time in A...
January 15, 2019: Food Chemistry
J Ingham, R Angotti, M Lewis, A Goyal
INTRODUCTION: Botulinum toxin-A (BtA) has been used for refractory idiopathic overactive bladder (IOAB) in children. Data on the optimum dose success rates, duration of effect, complications and medium-term outcomes are limited. This study aims to analyse the authors' experience to provide medium-term results of BtA in symptomatic refractory patients. MATERIALS AND METHODS: Patients with refractory IOAB who were treated with BtA (Botox®) were retrospectively analysed...
August 16, 2018: Journal of Pediatric Urology
David Snipelisky, Justin Shipman, Nicole Olson, Patricia Pellikka, Bashar Aqel, Robert McCully, Kymberly Watt
INTRODUCTION: Dobutamine stress echocardiography (DSE) is frequently used to screen for obstructive coronary artery disease in the pre-liver transplant evaluation. Although atropine is a commonly used adjunctive medication, no study has evaluated its side effect profile in patients with end-stage liver disease (ESLD). RESEARCH QUESTION: What is the safety of atropine in candidates undergoing pre-liver transplant evaluation when atropine is used in stress testing? DESIGN: This multicenter, prospective study enrolled patients over a 6-month period undergoing pre-liver transplant evaluation...
September 16, 2018: Progress in Transplantation
A Ivchenko, R-H Bödeker, C Neumeister, A Wiedemann
BACKGROUND: Elderly people are representative for the patients most likely to be treated with anticholinergics for overactive bladder (OAB). They often receive further drugs with anticholinergic properties for concomitant conditions. This increases the risk for side effects, including central nervous system disorders. Data on comorbidities and baseline anticholinergic burden of OAB patients seen in urological practice is scarce. Therefore, we included an epidemiological survey on these issues in our study which assessed the effectiveness and tolerability of trospium chloride (TC) in established dosages under routine conditions...
September 14, 2018: BMC Urology
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