Dicyclomine anticholinergic

Geriatric Considerations - Summary Dicyclomine is a weak anticholinergic but has the potential to cause adverse effects in the older adult, including urinary retention, hypotension, and confusion. The potential for adverse effects limits the usefulness of this drug for older adults. 

Dicyclomine, hyoscine etc. Details are given in chapter Anticholinergic agents ... 

Dicyclomine (Bentyl) [Anrimuscarinic, GI Anrispasmodic/ Anticholinergic] Uses Functional IBS Action Smooth-muscle relaxant Dose Adults. 20 mg PO qid T to 160 mg/d max or 20 mg EM q6h, 80 mg/d - qid then T to 160 mg/d, max 2 wk Feds. Infants >6 mo 5mg/dose tid-qid Children 10 mg/dose tid-qid Caution [B, -] Contra Infants <6 mo, NAG, MyG, severe UC, BOO Disp Caps, tabs, syrup, inj SE Anticholinergic SEs may limit dose Interactions T Anticholinergic effects W/ anticholinergics, antihistamines, amantadine, MAOIs, TCAs, phenothiazides T effects OF atenolol, digoxin X effects H7 antacids X effects OF haloperidol, ketoconazole, levodopa, phenothiazines EMS Avoid procainamide usage, may T adverse effects may T effects of digoxin, monitor... 

As a class, anticholinergics include the antihistamines, atropine and homatropine anti-Parkinsonian agents like benzotropine, procyclidine, and trihexyphenidyl the antimuscarinics of which atropine is the prototype and antispasmodics like dicyclomine and oxybutymin. Most antimuscarinics are amino-alcohols or their derivatives (usually esters or ethers), aminoamides, or other amines. Antimuscarinics can be divided into two groups. These are the naturally occurring alkaloids and their semisynthetic derivatives like atropine, homatropine, scopolamine, and hyoscyamine and the synthetic amine compounds such as anisotropine, dicyclomine, and ipratropium. 

Colitis may result from various gut infections, especially amoebic colitis. Clindamycin, vancon cin or metronidazole may be used in treatment. The diarrhoea of colitis states may be treated with normal ANTIDIARRHOEALS, e.g. the opioids codeine, morphine, diphenoxylate and loperamide. The colic may respond to ANTISPASMODICS, e.g. the anticholinergics atropine, hyoscine, dicyclomine, propantheline. Meheverine is a direct-acting antispasmodic effective in some types of gut colic. 

Dicyclomine hydrochloride, an anticholinergic agent that relaxes smooth muscle, produced minimal benefit as well as bothersome adverse effects in two small studies. ... 

Dicyclomine is an anfispasmodic agent that relieves smooth-muscle spasm of the G1 tract through anticholinergic effects and direct action on G1 smooth muscle. It is indicated in the treatment of functional bowel/irritable bowel syndrome (e.g., irritable colon, spastic colon, and mucous colitis). 

Cholestyramine can be used to prevent bile salt induced colonic secretion in patients who have undergone limited ileocolic resections. Anticholinergic agents (dicyclomine hydrochloride, etc. see Chapter 7) are used to reduce abdominal cramps, pain, and rectal urgency. As with the antidiarrheal agents, they are contraindicated in severe disease or when obstruction is suspected. Care should be taken to dijferentiate exacerbation ofIBDfrom symptoms that may be related to coexistent functional bowel disease (see Chapter 37). 

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