Anticholinergics drug reaction

When taking an anticholinergic drug for parkinsonism, the patient would mostly experience which of the following adverse reactions ... 

Specific anticholinergic drug are occasionally used in die medical treatment of peptic ulcer. These drug have been largely replaced by histamine H2 antagonists, which appear to be more effective and have fewer adverse drug reactions. 

Dry mouth, blurred vision, urinary hesitancy, urinary retention, nausea, vomiting, palpitations, and headache are some of die adverse reactions that may be seen witii die use of anticholinergic drug (see Chap. 25). 

Acute extrapyramidal reactions occur more often after ingestion of high-potency drugs, such as haloperidol and fluphenazine these respond to parenteral benzatropine, but anticholinergic drugs should be used judiciously, so as not to worsen peripheral or central autonomic toxicity. Other serious, but less frequent, complications include paralytic ileus and hypothermia. Acute renal insufficiency has been very rarely reported, but is apparently reversible and can occur secondary to severe hypotension or other causes after acute ingestion (615). 

In the absence of additional reports of long-range consequences In subjects who had received the anticholinergic test compounds, data have been sought on delayed adverse reactions to other anticholinergic drugs used therapeutically, such as Oltran and atropine. 

Orofacial dyskinesia, though familiar with dopaminergic drugs, can apparently also occur with some anticholinergic drugs for example, it has been described with trihexyphenidyl in a patient who did not have this reaction with levodopa (SEDA-18, 160). 

Benzatropine and etybenzatropine (ethylbenzatropine) are anticholinergic drugs. They represent attempts to combine atropine-like and antihistaminic effects in single molecules. The dose is determined individually and varies from 0.5 to 6 mg/day for benzatropine and 6 to 30 mg/day for etybenzatropine. Although the adverse reactions are essentially those of the anticholinergic drugs, sedation is very likely to occur and these drugs should not be used in patients who need to drive motor vehicles. Benzatropine has also been reported to cause rash, peripheral numbness, and muscular weakness. 

The use of cisapride and its benefit to harm balance in children has been reviewed (25). Overall it is well tolerated. The most common adverse effects are diarrhea, abdominal cramps, borborygmi, and colic. Serious adverse events are rare and include isolated cases of extrapyramidal reactions, seizures in epileptic patients, cholestasis, QT interval prolongation and ventricular dysrhythmias, anorexia, and enuresis. Interactions of cisapride with other drugs are similar to those reported in adults. Co-administration of drugs that inhibit CYP3A4, such as imidazoles, macrolide antibiotics, the antidepressant nefazodone, and protease inhibitors such as ritonavir, are contraindicated. Furthermore, co-administration of anticholinergic drugs can compromise the beneficial effects of cisapride. 

Acute extrapyramidal reactions occur more often after ingestion of high-potency drugs, such as haloperidol and fluphenazine these respond to parenteral benzatropine, but anticholinergic drugs should be used judiciously, so as... 

Trihexyphenidyl (benzhexol) is an anticholinergic drug. It is given in oral doses rising from 2 to 20 mg/day, and even higher doses are used in dystonic patients. A wide range of anticholinergic adverse reactions can occur, but trihexyphenidyl is apparently particularly likely to cause excitement. 

Table 1. Allergic reactions to anticholinergic drugs reported to the Swedish National Board of Health 1967-1978...

Cyclopentolate is an anticholinergic drug used in eye drops as a mydriatic. It can cause both local [19 ] and systemic adverse reactions [20, 21 ]. 

Frequently seen adverse reactions to dragp with anticholinergic activity include dry mouth, blurred vision, dizziness, mild nausea, and nervousness. These may become less pronounced as therapy progresses. Other adverse reactions may include skin rash, urticaria (hives), urinary retention, dysuria, tachycardia, muscle weakness, disorientation, and confusion. If any of these reactions are severe, the drug may be discontinued for several days and restarted at a lower dosage, or a different antiparkinsonism drag may be prescribed. 

D contact the prescriber and report that the patient is suffering a hypersensitivity reaction to the drug E inform the prescriber that an anticholinergic agent needs to be prescribed to this patient... 

Concomitant conditions Use with caution in the following patients exposed to extreme heat or phosphorus insecticides atropine or related drugs because of additive anticholinergic effects those in a state of alcohol withdrawal those with dermatoses or other allergic reactions to phenothiazine derivatives because of the possibility of cross-sensitivity those who have exhibited idiosyncrasy to other centrally acting drugs. 

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