Glaucoma anticholinergics

Narrow-angle glaucoma Anticholinergics Glaucoma attack... 

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. 

Closed-angle glaucoma Topical anticholinergics Topical sympathomimetics Systemic anticholinergics Heterocyclic antidepressants Low-potency phenothiazines Antihistamines Ipratropium... 

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) The anticholinergic effect of procainamide would aggravate glaucoma. 

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. 

Contraindications GI or genitourinary (GU) obstruction, myasthenia gravis, narrow-angle glaucoma, toxic megacolon, severe ulcerative colitis, unstable cardiovascular adjustment in acute hemorrhage, hypersensitivity to propantheline or other anticholinergics... 

The antimuscarinic properties result in what are usually the most troublesome adverse effects dry mouth, blurred vision, constipation, and (mainly in older males) urinary hesitancy and retention. Pupil size, and hence risk of glaucoma, is determined by a balance between anticholinergic (mydriatic) and sympathomimetic (miotic) effects. 

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. 

Physostigmine Antilirium, Eserine, Isopto Eserine Glaucoma, reversal of CNS toxicity caused by anticholinergic drugs... 

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. 

Clozapine s anticholinergic effects can cause confusion and delirium as well as sedation and lethargy. The severity of withdrawal psychosis may be due to cholinergic rebound. Clozapine can aggravate or cause hypersalivation, glaucoma, constipation and ileus, and urinary retention (Baldessarini et al., 1991). Weight gain is also a potentially very serious problem. 

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