Anticholinergic drugs, preparation

AChE, acetylcholinesterase CNS, central nervous system COPD, chronic obstructive pulmonary disease. PREPARATIONS AVAILABLE Antimuscarinic Anticholinergic Drugs ... 

The following synthetic route is used to prepare an intermediate in the total synthesis of the anticholinergic drug benzilonium bromide. 

The prototype antihistamine of this group is diphenhydramine. It has antimuscarinic and pronounced central sedative properties and also an antitussive effect. The mechanism of the latter is unclear, but diphenhydramine is a common ingredient of propriety preparations for the treatment of coughs and colds. It is an effective anti-emetic, especially useful for prevention and treatment of motion sickness. Because of its anticholinergic properties it is occasionally used in the treatment of mild forms of Parkinson s disease. It is also of use in the treatment of drug-induced extrapyramidal effects. Piperazine derivatives... 

Adverse anticholinergic effects can occur immediately after the first dose of a tricyclic antidepressant. They are a major cause of poor compliance in patients who expect immediate relief, but who are not properly prepared for the delay that can occur in the beneficial effects of these drugs on mood and energy. 

Drugs reported to affect aqueous tear secretion are listed in Table 35-6. Among the agents that frequently reduce tear secretion are the anticholinergics and antihistamines. These classes of drugs are also present in numerous over-the-counter products such as sedatives, sleep aids, cold preparations, antidiarrheals, and nasal decongestants. 

Aucamp and Meyer (131) reported that well- Controlled epileptics may experience sudden exacerbation of their seizures If they begin taking drugs with anticholinergic activity (as In some antacid preparations) or antlhlstamlnlc activity (as In preparations for amelioration of colds and Influenza). 

Many commonly used drugs have sympatholytic, anticholinergic, sedative, or antiandrogenic effects that may exacerbate or contribute to the development of erectile dysfunction. Clinicians should be familiar with these agents and be prepared to make adjustments in drug regimens to minimize adverse effects of these drugs on a patient s erectile function. 

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