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Related Concept Videos

Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

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Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
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Direct-Acting Cholinergic Agonists: Therapeutic Uses01:11

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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:    
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A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
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The anticholinergic burden: from research to practice.

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Anticholinergic burden from medications can harm older adults, causing side effects and cognitive decline. Deprescribing these drugs may reverse adverse effects and prevent falls.

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Area of Science:

  • Gerontology
  • Clinical Pharmacology
  • Public Health

Background:

  • Anticholinergic drugs cause adverse effects like dry mouth, constipation, and urinary retention.
  • In older adults, anticholinergic effects can lead to cognitive decline and functional impairment.
  • Many medications outside the anticholinergic class possess these effects, contributing to an overall anticholinergic burden.

Purpose of the Study:

  • To highlight the risks associated with anticholinergic burden in older populations.
  • To emphasize the importance of identifying patients at risk.
  • To advocate for the use of assessment tools for pharmacological risk evaluation.

Main Methods:

  • Review of literature on anticholinergic effects and burden.
  • Discussion of tools available for anticholinergic burden assessment.
  • Exploration of the concept of deprescribing anticholinergic medications.

Main Results:

  • Anticholinergic burden is a significant risk factor for adverse events in the elderly.
  • Multiple medications can contribute to this burden, even if not classified as anticholinergic.
  • Assessment tools can aid clinicians in managing medication risks.

Conclusions:

  • Identifying and reducing anticholinergic burden is crucial for older adults' health.
  • Deprescribing these medications offers potential benefits, including reversing side effects.
  • Reducing anticholinergic burden may prevent falls and improve functional capacity in the elderly.