Benzodiazepines 4- Anticholinergics

Keywords Inappropriate drugs Beer s criteria Antipsychotics Benzodiazepines Anticholinergic drugs NSAID... 

Drugs used recreationally - LSD, MDMA, phencyclidine, ketamine, cannabis, volatile solvents, opioids, cocaine, amphetamines, benzodiazepines, anticholinergics. 

Opioids, benzodiazepines, barbiturates, corticosteroids, dopamine agonists (e.g., amantadine, bromocriptine, levodopa, pergolide, pramipexole, ropinirole), H2-receptor antagonists, anticholinergics (e.g., diphenhydramine, trihexylphenidyl), P-adrenergic blockers, clonidine, methyldopa, carbamazepine, phenytoin, baclofen, cyclobenzaprine, lithium, antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors), and interleukin-2... 

A number of medications have been associated with an increased risk of falling, including drugs affecting mental status such as antipsychotics, benzodiazepines, tricyclic antidepressants, sedative-hypnotics, anticholinergics, and corticosteroids. Some cardiovascular and antihypertensive drugs also can contribute to falls, especially those causing orthostatic hypotension.9... 

Medications for symptomatic relief from vertigo consist of antiemetics, benzodiazepines and antihistamines. They are all mostly aimed at the psychological consequences of dizziness and can all have highly unfavourable side effects, for example, sedation, anticholinergic effects and insomnia. The psychological consequences of dizziness in elderly should rather be treated with information about the condition, supportive help actions and increased social activities, than with drugs. 

During the maintenance phase, treatment can be fine-tnned. If persistent side effects (especially EPS) are a problem, then the antipsychotic can be gradnally switched or conntermeasures snch as anticholinergic therapy can be taken. In addition, maintenance therapy is also an appropriate time to address the less dramatic bnt nonetheless tronblesome symptoms snch as a mood distnrbance. Antidepressants are often used to treat depressed mood in patients with schizophrenia. Likewise, benzodiazepines are commonly nsed with an antipsychotic to treat persistent yet subsyndromal anxiety in schizophrenia patients. 

Other sleep-inducing benzodiazepines should be avoided. They are more difficult to metabolize and can accumulate in elderly, demented patients. Sedating, low potency antipsychotics should also be avoided. Their strong anticholinergic (acetylcholine-blocking) effects can worsen dementia or cause delirium. 

Drugs that may affect maprotiline include thyroid hormones, benzodiazepines, and phenothiazines. Drugs that may be affected by maprotiline include anticholinergics. 

In anesthesia drugs from several groups are used as premedication. Pre-anesthetic medication can decrease the anesthetic doses which otherwise would be required to induce anesthesia and so decrease the risk for adverse effects. Pre-anesthetic medication will increase the rate of induction of anesthesia and can reduce pre-operative pain and anxiety. Drugs include benzodiazepines for sedation and their muscle relaxant properties, opiates for pain relieve and anticholinergics or histamine Hi receptor antagonists against nausea and vomiting. Neuroleptics are also used as premedication for their antiemetic effects. 

The incidence of akathisia is about 20% the syndrome consists of intense motor restlessness and agitation that contribute to a behavioral deterioration. It is frequently unresponsive to anticholinergics and is more effectively treated with benzodiazepines and 3-adrenergic antagonists, such as propranolol. 

Contraindications Anticholinergic signs (such as mydriasis, dry mucosa, and hypo-peristalsis), arrhythmias, cardiovascular collapse, history of hypersensitivity to benzodiazepines, patients with signs of serious cyclic antidepressant overdose (such as motor abnormalities), patients who have been given a benzodiazepine for control of a potentially life-threatening condition (such as control of status epilepticus or increased intracranial pressure ICP )... 

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