title: Simultaneous usage of dementia medications and anticholinergics among Asians and Pacific Islanders.
abstract: BACKGROUND
  The simultaneous use of dementia medications and anticholinergic medications occurs frequently. Cholinesterase inhibitors and anticholinergic medications likely counteract one another, potentially exposing patients to medications with decreased benefit, more adverse effects, and higher cost of care. We identified the rate of concurrent prescriptions of cholinesterase inhibitors/memantine with anticholinergics in an urban hospital setting with a large Asian and Pacific Islander population.
  
  
  METHODS
  This study is a retrospective review of patients hospitalized from 1 January 2006 to 31 December 2010 at a general hospital who simultaneously received US Food and Drug Administration-approved dementia medications (galantamine, rivastigmine, donepezil, and/or memantine) and anticholinergics.
  
  
  RESULTS
  Overall, 304 patients receiving cholinesterase inhibitors/memantine also received anticholinergics. Of these patients, 64.1% were given high-potency anticholinergic medications, and 35.9% received medium-potency medications. Indications for the use of anticholinergic medication were urological (17.8%), gastrointestinal excluding nausea (32.6%), nausea (10.2%), psychiatric (7.9%), and other (31.6%). Asian patients received the combination of cholinesterase inhibitors/memantine and anticholinergics less frequently than Native Hawaiian or Caucasian patients (8.4% vs 12.2% and 13.3%, respectively; χ2= 16.04, degrees of freedom = 2, P < 0.0003).
  
  
  CONCLUSIONS
  Simultaneous prescribing of cholinesterase inhibitors, memantine, and anticholinergic medications was significantly less common than in previous studies, with some ethnic variability. The less frequent occurrence of concurrent medications in the Asian population may be because of variations in the rate of indications or in tolerability for anticholinergic medications among the population.
authors.affiliation: Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.|The Queen's Medical Center, Honolulu, Hawaii, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Schultz
authors.affiliation: Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.|The Queen's Medical Center, Honolulu, Hawaii, USA.
authors.forename: Junji
authors.initials: J
authors.lastname: Takeshita
authors.affiliation: Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.|The Queen's Medical Center, Honolulu, Hawaii, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Goebert
authors.affiliation: Princeton University, Princeton, New Jersey, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Takeshita
authors.affiliation: Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.|The Queen's Medical Center, Honolulu, Hawaii, USA.
authors.forename: Brett Y
authors.initials: BY
authors.lastname: Lu
authors.affiliation: The Queen's Medical Center, Honolulu, Hawaii, USA.|Department of Cell and Molecular Biology, University of Hawaii, Honolulu, Hawaii, USA.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Guilloux
authors.affiliation: Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Higa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000188:drug therapy* / Q000208:ethnology; D000077265:Donepezil; D005260:Female; D005702:Galantamine / Q000627:therapeutic use; D006254:Hawaii / Q000453:epidemiology; D006786:Hospitals, Urban; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D010139:Pacific Islands / Q000453:epidemiology; D010880:Piperidines / Q000627:therapeutic use; D012189:Retrospective Studies; D000068836:Rivastigmine / Q000627:therapeutic use
chemical_list: D018680:Cholinergic Antagonists; D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine; D008559:Memantine
keywords: 
  Asian Continental Ancestry Group; cholinergic antagonists; cholinesterase inhibitors; dementia; memantine