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Related Concept Videos

Indirect-Acting Cholinergic Agonists: Pharmacological Actions01:30

Indirect-Acting Cholinergic Agonists: Pharmacological Actions

613
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.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
613
Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

780
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
780
Cholinergic Antagonists: Pharmacological Actions01:28

Cholinergic Antagonists: Pharmacological Actions

820
Antimuscarinic drugs block muscarinic receptors in multiple systems, including the gut, eye, smooth muscles, respiratory tract, cardiovascular, and central nervous systems. They produce similar effects with varying selectivity depending on the specific agent and tissue. Here are the key pharmacological actions of antimuscarinics:
Gastrointestinal Effects: Antimuscarinics reduce gut contractions, increase gastric emptying, and slow intestinal transit. They partly inhibit gastric acid secretion...
820
Cholinergic Antagonists: Therapeutic Uses01:26

Cholinergic Antagonists: Therapeutic Uses

707
Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:    
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal...
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Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

202
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
202
Cholinergic Antagonists: Pharmacokinetics01:24

Cholinergic Antagonists: Pharmacokinetics

407
Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations,  while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and...
407

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Related Experiment Video

Updated: Jun 1, 2025

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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[Anticholinergic burden in the elderly].

M Rodríguez Casal1

  • 1Farmacéutica comunitaria en Ferrol (La Coruña) España.

Farmaceuticos Comunitarios
|January 20, 2025
PubMed
Summary

High anticholinergic burden from medications is common in elderly patients, potentially causing physical and cognitive issues. Prescribers should consider this burden to mitigate adverse effects in older adults.

Area of Science:

  • Gerontology
  • Clinical Pharmacology
  • Neuroscience

Background:

  • Anticholinergic drugs are frequently prescribed for common conditions like Parkinson's disease, depression, and allergies.
  • Previous research suggests a link between high anticholinergic burden and adverse physical and cognitive outcomes in elderly individuals with multiple medications.

Purpose of the Study:

  • To review existing hypotheses on the relationship between high anticholinergic burden and functional decline in the elderly.
  • To investigate the association between anticholinergic burden and cognitive and physical dysfunctions in polymedicated older adults.

Main Methods:

  • Conducted a comprehensive bibliographic review of current literature on anticholinergic burden and its effects.
  • Designed and implemented a cross-sectional study involving patients over 70 years old on multiple medications.
Keywords:
Anticholinergicagedcognitivedysfunction

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  • Calculated the anticholinergic burden for each patient's medication regimen and assessed for cognitive and physical dysfunctions.

    • Main Results:

    • Identified a high prevalence of anticholinergic medication prescriptions among elderly patients.
    • Observed a correlation between high anticholinergic burden and the occurrence of adverse effects.
    • Found that high anticholinergic burden may contribute to physical and cognitive deterioration in the elderly.

    Conclusions:

    • The study highlights the significant prevalence of anticholinergic drug use in the elderly population.
    • Results underscore the potential negative impact of anticholinergic burden on the physical and cognitive health of older adults.
    • Emphasizes the critical need for clinicians to consider anticholinergic burden during the prescribing process for elderly patients.