Methods for assessing drug-related anticholinergic activity.
The geriatric population is a large consumer of both prescription and over-the-counter drugs. Positive outcomes from drugs depend on the delicate interplay between therapeutic and adverse effects. This relationship becomes tortuous with simultaneous administration of several drugs. Numerous concomitant drug therapies may be essential for providing quality patient care but may also increase the possibility of an adverse drug event. Increasing sensitivity to drug effects in the geriatric population also creates concern over adverse effects. Drugs that possess anticholinergic properties are especially worrisome, as these properties may manifest as hazardous physiologic and psychological adverse drug events. Consequently, clinicians strive to minimize total drug exposure to agents possessing anticholinergic properties in elderly patients. A review of the literature revealed four methods that might help clinicians systematically reduce or eliminate potentially offending anticholinergic drugs. Each of the four has merits and limitations, with no ideal evidence-based approach used. Three of the four methods described have research utility; however, only one of the methods is clinically useful.
Rudd
Kelly M
KM
Section of Clinical Pharmacology, Department of Pharmaceutical Care Services, Bassett Healthcare, Cooperstown, New York 13326, USA. kelly.rudd@bassett.org
Raehl
Cynthia L
CL
Bond
C A
CA
Abbruscato
Thomas J
TJ
Stenhouse
Andrew C
AC
D018680:Cholinergic Antagonists / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D011976:Receptors, Muscarinic / Q000378:metabolism
D018680:Cholinergic Antagonists; D011976:Receptors, Muscarinic