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anticholinergic effects

Vasiliki Kalogera, Dimitrios Galopoulos, Gerasimos Eleftheriotis, Evangelia Meimeti, Ioannis Malios, Georgios Marathonitis, Chariclia Loupa
Introduction: Oxcarbazepine is a carbamazepine pre-drug with less drug interactions. Its adverse effects, including hyponatremia, somnolence and ataxia, are dose dependent. Olanzapine is an atypical antipsychotic drug most commonly used to manage psychoses and symptoms of irritability and aggressive behavior. Main side effects include extrapyramidal and anticholinergic symptoms, weight gain, and hyperglycemia. Case Report: In this manuscript a case of oxcarbazepine and olanzapine intoxication is discussed...
October 2018: Medical Archives
Brian Murray, Sam H Hessami, Dmitry Gultyaev, Johanna Lister, Roger Dmochowski, Kristin Khalaf Gillard, Sanja Stanisic, Amy Tung, Robert Boer, Steven Kaplan
AIM: To assess the cost-effectiveness of onabotulinumtoxinA (onabotA), implantable sacral nerve stimulation devices, percutaneous tibial nerve stimulation, anticholinergic medications and mirabegron compared with best supportive care (BSC) for management of refractory overactive bladder (OAB). METHODS: A Markov model was developed to compare the cost-effectiveness of treatment options with BSC over a 10-year time horizon. Resource utilization, discontinuation rates and costs were derived from unpublished and published sources...
December 4, 2018: Journal of Comparative Effectiveness Research
Young-Mi Ah, Yewon Suh, Kwanghee Jun, Sunghee Hwang, Ju-Yeun Lee
Few studies have evaluated the association between anticholinergic burden and treatment modification after starting a cholinesterase inhibitor in clinical practice. We aimed to evaluate the effect of anticholinergic burden on anti-dementia treatment modification, delirium and mortality. We retrospectively analysed older adults (n = 25,825) who started a cholinesterase inhibitor during 2003-2011 from Korean National Health Insurance Service Senior Cohort Database. High anticholinergic burden was defined as an average daily Anticholinergic Cognitive Burden (ACB) score of >3 during the first three months...
December 3, 2018: Basic & Clinical Pharmacology & Toxicology
Heinrich Schulte-Baukloh, Ricarda Bauer, Wolfgang Jost, Jörg Wissel, Arndt van Ophoven
An overactive neurogenic detrusor and an non-neurogenic overactive bladder both exhibit symptoms such as urgency and frequency, both with and without urinary incontinence, and are often accompanied by nocturia. OnabotulinumtoxinA-Detrusorinjection has become well established as a second line therapy in cases where anticholinergic medication has failed. The procedure can be performed under general or local anesthesia, in both in- and outpatient settings. The side effects of the procedure are primarily urinary tract infections and - especially in neurogenic bladder patients - urinary retention...
December 3, 2018: Fortschritte der Neurologie-Psychiatrie
H Luckhoff, L Phahladira, F Scheffler, L Asmal, S du Plessis, B Chiliza, S Kilian, R Emsley
BACKGROUND: Treatment-emergent weight gain is associated with antipsychotic efficacy in schizophrenia patients treated with clozapine and olanzapine. However, few studies have investigated this relationship in first-episode patients treated with other antipsychotics, in particular those with a lower obesogenic potential. Aim To investigate the relationships between weight gain and associated metabolic changes with psychopathology improvement in relation to age, sex, ethnicity, substance use, treatment duration and antipsychotic dose in first-episode schizophrenia spectrum disorder patients...
November 29, 2018: Schizophrenia Research
Min Jung Lee, Jun-Hwan Moon, Hyung Keun Lee, Chong Hwan Cho, Sung Hak Choi, Weon-Bin Im
Several antimuscarinics have been commonly used for overactive bladder patients, but dry mouth as a major anticholinergic side effect remains a shortcoming to limit long-term use. The aim of this study was to elucidate the pharmacological properties of DA-8010, a novel muscarinic receptor antagonist selective for urinary bladder over salivary gland. DA-8010 exhibited a high binding affinity for human muscarinic M3 receptor with pKi of 8.81 ± 0.05 and great potencies for human M3 receptor and rat bladder preparation...
November 28, 2018: European Journal of Pharmacology
(no author information available yet)
Camptocormia is a rare, involuntary movement disorder, presenting as truncal flexion while standing or walking, and is mainly observed as a feature of Parkinson's disease (PD) and primary dystonia. Deep brain stimulation (DBS) of the globus pallidus internus is effective for refractory camptocormia observed with PD or dystonia. However, the effectiveness of pallidotomy for camptocormia has not been investigated. The authors report the case of a 38-year-old man with anterior truncal bending that developed when he was 36 years old...
October 1, 2018: Journal of Neurosurgery
Luca Pasina, Lorenzo Colzani, Laura Cortesi, Mauro Tettamanti, Antonella Zambon, Alessandro Nobili, Andrea Mazzone, Paolo Mazzola, Giorgio Annoni, Giuseppe Bellelli
BACKGROUND: Delirium is a neuropsychiatric syndrome which occurs on average in one out of five hospitalized older patients. It is associated with a number of negative outcomes, including worsening of cognitive and functional status, increasing the burden on patients and caregivers, and elevated mortality. Medications with anticholinergic effect have been associated with the clinical severity of delirium symptoms in older medical inpatients, but this association is still debated. OBJECTIVE: The aim was to assess the association between delirium and anticholinergic load according to the hypothesis that the cumulative anticholinergic burden increases the risk of delirium...
November 27, 2018: Drugs & Aging
Thanompong Sathienluckana, Weerapon Unaharassamee, Chuthamanee Suthisisang, Orabhorn Suanchang, Thanarat Suansanae
Introduction: Cognitive impairment is a core feature and shows the highest impact on functional outcome in patients with schizophrenia. There have been no previous studies investigating the role of the pharmacist in a multidisciplinary team on cognitive outcomes in patients with schizophrenia. Purpose: We evaluated the impact of pharmacist intervention on cognitive outcomes in patients with schizophrenia by focusing on anticholinergic discontinuation. Patients and methods: A prospective, open-label, randomized, controlled study was conducted...
2018: Integrated Pharmacy Research and Practice
Maciej Kupczyk, Piotr Kuna
The triple therapy term covers the combination of inhaled corticosteroid (ICS), long-acting β-receptor agonist (LABA) and long-acting anticholinergic drug (LAMA) in one or in separate inhalers. The latest GOLD 2018 (Global Initiative for Chronic Obstructive Disease) guidelines recommend the triple therapy in the management of chronic obstructive pulmonary disease (COPD) in patients of group D who despite the combination of two drugs: LAMA/LABA or ICS/LABA continue to have persistent symptoms or suffer from further frequent exacerbations...
November 21, 2018: Expert Review of Respiratory Medicine
Susanna Every-Palmer, Stephen J Inns, Eve Grant, Pete M Ellis
BACKGROUND: Gastrointestinal hypomotility in people taking clozapine is common, poorly understood and potentially dangerous. It causes distress and sometimes sudden death, with greater associated morbidity than the better known adverse effect of clozapine, agranulocytosis. Neither the mechanism nor prevalence of clozapine-induced gastrointestinal hypomotility is well understood. Previous studies show clozapine impedes colon transit, likely owing to anticholinergic and anti-serotonergic properties...
November 19, 2018: CNS Drugs
Ara Koh, Kwan Cheol Pak, Hee Youn Choi, Sunae Ryu, Seung-Eun Choi, Ki Soon Kim, Kyun-Seop Bae, Hyeong-Seok Lim
Amitriptyline is a tricyclic antidepressant that is metabolized mainly by CYP2C19 and CYP2D6 enzymes. Higher plasma levels of amitriptyline and its active metabolite, nortriptyline, are associated with an increased risk of adverse events including anticholinergic effects. The aim of this study was to evaluate the effects of CYP2C19 and CYP2D6 genetic polymorphisms on amitriptyline and nortriptyline pharmacokinetics. Twenty-four Korean healthy adult male volunteers were enrolled in the study after stratification by their CYP2C19 and CYP2D6 genotypes...
November 19, 2018: Journal of Clinical Pharmacology
Andrea Corsonello, Annalisa Cozza, Sonia D'Alia, Graziano Onder, Stefano Volpato, Carmelinda Ruggiero, Antonio Cherubini, Mirko Di Rosa, Paolo Fabbietti, Fabrizia Lattanzio
BACKGROUND: The relationship between anticholinergic burden and mortality is controversial, and the impact of anticholinergic burden on prognosis may vary in presence of other conditions common in old age. We aimed at investigating the role of depressive symptoms as potential effect modifiers in the association between anticholinergic burden and 1-year mortality in older patients discharged from hospital. METHODS: Our series consisted of 576 older patients consecutively admitted to seven geriatric and internal medicine acute care wards in the context of a prospective multicenter observational study...
November 15, 2018: European Journal of Internal Medicine
Suleyman Sami Cakir, Recep Burak Degirmentepe, Hasan Anil Atalay, Halil Lutfi Canat, Sait Ozbir, Mehmet Gokhan Culha, Emre Can Polat, Alper Otunctemur
PURPOSE: The aim of the study was to determine the effect of anticholinergics used for overactive bladder treatment on the sexual function of women. METHODS: Between January 2016 and August 2018, over 18 years old, 216 sexual active women with OAB and 165 healthy women as control group were prospectively enrolled in the study. Five different anticholinergics were used for the treatment. Female Sexual Function Index (FSFI), eight-item overactive bladder awareness tool (OAB-V8), and Beck Depression Inventory form were completed before and after 3 months...
November 17, 2018: International Urology and Nephrology
Moreno Marchiafava, Massimo Piccirilli, Chiara Bedetti, Antonella Baglioni, Marina Menna, Sandro Elisei
Neurodevelopmental disorders often result in disabilities associated with auto- and / or hetero-aggressive behaviors, that can be defined as "problem behaviors" (Lacy 2007). Therapeutic interventions are mainly directed towards the use of neuroleptic drugs or benzodiazepines, to ensure a rapid and significant sedation in most of cases. These pharmacological devices exposes the patient to clinical risks and/or long-term management difficulties. The main problem of the chronic use of benzodiazepines is the development of tolerance and dependence; furthermore benzodiazepine withdrawal or their abrupt reduction may lead to rebound effect...
November 2018: Psychiatria Danubina
Hepsen Mine Serin, Bediz Ozen, Sanem Yilmaz
Anisocoria is a significant finding in several ocular and potentially life-threatening neurological disorders. The angel's trumpet (Datura suaveolens), widely used as a garden plant, is a natural alkaloid with anticholinergic effects containing high levels of scopolamine. The authors present a pediatric case of acute anisocoria secondary to contact with the angel's trumpet plant. This case report emphasizes the importance of considering herbal mydriatics in patients with acute, isolated, unilateral mydriasis...
November 2, 2018: Journal of Pediatric Ophthalmology and Strabismus
Sandra Mühlstädt, Shahidul Mischner, Jennifer Kranz, Petra Anheuser, Nasreldin Mohammed, Joachim A Steffens, Paolo Fornara
Background: Idiopathic overactive bladder (iOAB), with or without urge incontinence (UI), has significant psychosocial effects on patients' quality of life (QoL). The first choice of treatment for iOAB is anticholinergics and, alternatively, the β-3-adrenoceptor agonist mirabegron. However, systemic side effects and contraindications should be considered for both medications. Objective: We report the efficacy, safety and effects on QoL of botulinum toxin therapy (onabotulinum toxin type A, BOTOX®, Allergan) among patients with iOAB ± UI...
2018: Frontiers in Surgery
Courtney Baetge, Kevin J Cummings, Michael Deveau
Radiation therapy requires repeated anesthetic administration to patients who often have multiple comorbidities contributing to an increased rate of anesthetic complications such as pneumonia. This is a retrospective observational study in which data were collected from 146 medical records of dogs receiving repeat anesthesia for radiation treatment from prior to management changes and compared to data from 149 cases treated after completion of management changes. The objective was to determine if changes in case management protocol that were put in place decreased the risk of pneumonia development among these patients...
October 29, 2018: Veterinary Radiology & Ultrasound
Duygu Kınay, Ahmet Zihni Soyata
OBJECTIVE: Extrapyramidal adverse effects of antipsychotic drugs are more reported in children. Biperiden is an anticholinergic agent to treat the adverse effects of antipsychotic drugs. The drug has the potential to induce delirium at toxic doses. However, data are scarce about delirium associated with biperiden in children. Thus far, a case of delirium has been associated with biperiden in an adolescent patient. We report the first case of delirium associated with use of biperiden in a preadolescent patient...
October 28, 2018: Current Drug Safety
James P Hummel, Martin L Mayse, Steve Dimmer, Philip J Johnson
Parasympathetic efferent innervation of the lung is the primary source of lung acetylcholine. Inhaled long-acting anticholinergics improve lung function and symptoms in patients with COPD. Targeted lung denervation (TLD), a bronchoscopic procedure intended to disrupt pulmonary parasympathetic inputs, is an experimental treatment for COPD. The physiologic and histologic effects of TLD have not previously been assessed. Eleven sheep and two dogs underwent circumferential ablation of the main bronchi with simultaneous balloon surface cooling using a lung denervation system (Nuvaira, Inc...
October 25, 2018: Journal of Applied Physiology
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