Anticholinergics glaucoma with

These drugp are contraindicated in those with a hypersensitivity to the anticholinergic dragp, those with glaucoma (angle-closure), pyloric or duodenal obstruction, peptic ulcers, prostatic hypertrophy, achalasia (failure of... 

Inhaled anticholinergics are well tolerated with the most common adverse effect being dry mouth. Occasional metallic taste has also been reported with ipratropium. Other anticholinergic adverse effects include constipation, tachycardia, blurred vision, and precipitation of narrow-angle glaucoma symptoms. Urinary retention could be a problem, especially for those with concurrent bladder outlet obstruction. 

TCAs are usually well tolerated at the lower doses used for migraine prophylaxis, but anticholinergic effects may limit use, especially in elderly patients or those with benign prostatic hyperplasia or glaucoma. Evening doses are preferred because of sedation. 

Anticholinergic activity Do not use in patients with urinary retention, glaucoma, or myasthenia gravis unless adequate overriding measures are taken. Males with benign prostatic hypertrophy are at particular risk of having urinary retention. In patients with a family history of glaucoma, measure intraocular pressure before... 

Special risk As an anticholinergic drug, tiotropium potentially may worsen signs and symptoms associated with narrow-angle glaucoma, prostatic hyperplasia, or bladder-neck obstruction use with caution in patients with any of these conditions. 

Because of the anticholinergic action of these agents, use with caution and with appropriate monitoring in patients with glaucoma, obstructive disease of the Gl or GU tract, and in elderly males with possible prostatic hypertrophy. These drugs may have a hypotensive action, which may be confusing or dangerous in postoperative patients. 

Use with caution in conditions which might be aggravated by anticholinergic therapy (eg, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, bladder neck obstruction, narrow angle glaucoma, bronchial asthma, cardiac arrhythmias). 

Anticholinergic effects Use with caution in patients with a history of urinary retention, urethral or ureteral spasm narrow-angle glaucoma, angle-closure glaucoma, or increased intraocular pressure. 

Anticholinergic properties Maprotiline should be administered with caution in patients with increased intraocular pressure, history of urinary retention, or history of narrow-angle glaucoma because of the drug s anticholinergic properties. 

CHF or peripheral edema Closely follow patients with a history of CHF or peripheral edema as there are patients who developed CHF while receiving amantadine. Glaucoma Because amantadine has anticholinergic effects and may cause mydriasis, do not give to patients with untreated angle closure glaucoma. 

Because of its anticholinergic properties, disopyramide should not be used in patients with glaucoma. Urinary retention and benign prostatic hypertrophy are also relative contraindications to disopyramide therapy. Patients with myasthenia gravis may have a myasthenic crisis after disopyramide administration as a result of the drug s local anesthetic action at the neuromuscular junction. The elderly patient may exhibit increased sensitivity to the anticholinergic actions of disopyramide. 

B. Anticholinergic agents, such as procainamide and disopyramide, are relatively contraindicated in patients with glaucoma. Procainamide is hypotensive rather than hypertensive. The local anesthetic activity of procainamide would have no adverse interaction with the diabetes mellitus. 

Percutaneous absorption is variable and may result in significant drowsiness in some patients. In view of the anticholinergic effect of doxepin, topical use is contraindicated in patients with untreated narrow-angle glaucoma or a tendency to urinary retention. 

Topical doxepin hydrochloride 5% cream (Zonalon) may provide significant antipruritic activity when utilized in the treatment of pruritus associated with atopic dermatitis or lichen simplex chronicus. The precise mechanism of action is unknown but may relate to the potent Hi and H2-receptor antagonist properties of dibenzoxepin tricyclic compounds. Percutaneous absorption is variable and may result in significant drowsiness in some patients. In view of the anticholinergic effect of doxepin, topical use is contraindicated in patients with untreated narrow-angle glaucoma or a tendency to urinary retention. 

A small number of cases of acute angle-closure glaucoma have been reported in patients treated with a combination of nebulised salbutamol and ipratropium bromide, caused possibly by local absorption of mist containing both products. A combination of nebulised salbutamol with nebulised anticholinergics should therefore be used cautiously. Patients should receive adequate instruction in correct administration and be warned not to let the solution or mist enter the eyes. Use of a mouthpiece rather than a mask for administration would reduce the risk associated with this. 

Loss of accommodation and blurred vision are common inconveniences that can usually be tolerated, in the knowledge that they lessen with the duration of treatment. Exacerbation of narrow-angle glaucoma in the elderly can occur, but is not an absolute contraindication to treatment with a tricyclic antidepressant, since the anticholinergic effects can be balanced by judicious use of pilocarpine (73,74). 

Tricyclic antidepressants predispose to acute angle closure glaucoma, probably through an anticholinergic action. However, acute angle closure has also been reported with SSRIs, suggesting that all serotonin-... 

Various neuroleptic drugs, particularly low-dose phe-nothiazines and thioxanthenes, commonly cause blurred vision secondary to their anticholinergic activity. This is primarily a nuisance, except in the rare patient with closed-angle glaucoma. 

Ocular side effects relate primarily to the anticholinergic properties of the Hi antihistamine. Accordingly, one can anticipate decreased secretion of tears and mucus and mydriasis with the potential of acute angle-closure glaucoma. Continued use can bring about decreased accommodation and decreased vision. Usually the therapy can continue, because the effects typically diminish with time. 

Antihistamines that produce sedation should not be used with alcohol or any other sedating drug, such as opioid analgesics. Antihistamines with strong anticholinergic effects should be avoided in patients with peptic ulcer disease, prostatic hypertrophy, or bladder or pyloro-duodenal obstruction and in patients who have the potential for acute angle-closure glaucoma. 

All anticholinergic drugs can cause acute closed-angle glaucoma in patients with an anatomical predisposition. They also cause photophobia and disturbances of accommodation leading to difficulties in reading and driving. 

Anticholinergic drugs clearly may cause problems in patients with closed-angle glaucoma (or a narrow angle between the iris and cornea), paralytic ileus, pyloric stenosis, or urinary retention. Because of their effects on temperature control they may be undesirable in patients with pyrexia (especially children) and during very hot weather. 

Because of the anticholinergic effects of disopyramide, care should be taken both in patients with symptoms of prostatic hjrperplasia (because of the risk of urinary retention) and in patients with glaucoma. 

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