Review literature Anticholinergic drugs: (Ouslander, 2004) (Yoshimura and Chancellor, 2002).
Mechanism of Action of Anticholinergic Drugs
Anticholinergic drugs act as antagonists on cholinergic (=muscarinic) receptors, this leads to smooth muscle relaxation of the bladder [see section receptors of the urinary bladder].
Indications for Anticholinergics:
- Autonomous detrusor contractions in neurogenic bladder dysfunction
- Overactive bladder syndrome
- Urge incontinence, urge symptoms in diseases like BPH, bladder infection, pelvic floor insufficiency, bladder catheterization ...
- Enuresis with urge symptoms oder overactivity of the bladder
Side Effects of Anticholinergics
Patients often do not complete the course of anticholinergic treatment due to the high rate of unwanted side effects:
- Disturbed accommodation
- Dry eyes due to inhibited lacrimal gland
- Dry mouth due to inhibited salivary glands
- Inhibition of intestinal motility (constipation)
- Dizziness, loss of concentration, drowsiness
- Aggravation of symptoms of dementia
- Fear, anxiety and confusion are possible psychiatric side effects
- Dry skin due inhibited sweat glands
Drug Interactions of Anticholinergics
Increased anticholinergic effect with antiparkinson drugs, antihistamines, antipsychotics, tricyclic antidepressants. Amplification of the tachycardic effect of sympathomimetic drugs. Anticholinergics mitigate the effects of gastrointestinal prokinetics.
Contraindications of Anticholinergics
- Narrow angle glaucoma
- Ileus, GI stenosis, severe inflammatory bowel disease, toxic megacolon
- Myasthenia gravis
- Urinary retention
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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Ouslander 2004 OUSLANDER, J. G.:
- Management of overactive bladder.
In: N Engl J Med
350 (2004), Nr. 8, S. 786–99
Yoshimura und Chancellor 2002 YOSHIMURA, N. ;
CHANCELLOR, M. B.:
- Current and future pharmacological treatment for overactive bladder.
In: J Urol
168 (2002), Nr. 5, S. 1897–913