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Anticholinergics (anticholinergic agents) are substances that block the action of the acetylcholine (ACh) neurotransmitter at synapses in the central and peripheral nervous system. [ 1 ] [ 2 ] These agents inhibit the parasympathetic nervous system by selectively blocking the binding of ACh to its receptor in nerve cells .
Glycopyrronium bromide is a medication of the muscarinic anticholinergic group. [7] It does not cross the blood–brain barrier and consequently has few to no central effects. It is given by mouth, [8] via intravenous injection, on the skin, [9] and via inhalation. [4] [5] [6] It is a synthetic quaternary ammonium compound. [2]
Intravenous benzodiazepine is used as a first-line treatment for agitation. Cooling measures are employed if there is any significant hyperthermia. Activated charcoal is only given within one hour of anticholinergic ingestion. Physostigmine is given only if presenting both peripheral and central signs and symptoms of anticholinergic poisoning. [23]
Oxybutynin, sold under the brand name Ditropan among others, is an anticholinergic medication primarily used to treat overactive bladder.It is widely considered a first-line therapy for overactive bladder due to its well-studied side effect profile, broad applicability, and continued efficacy over long periods of time.
Bornaprine Pathway. Bornaprine is an antimuscarinic agent that nonselectively antagonizes muscarinic acetylcholine receptors, M1 and M2. [8] Bornaprine has been characterized as a very potent anticholinergic medication and further clinical trials have indicated its effectiveness at treating parkinsonian tremors.
The main contraindication for ipratropium in any form is hypersensitivity to atropine and related substances. [20] [21]Conditions such as narrow-angle glaucoma, prostatic hyperplasia, or bladder neck obstruction are not necessarily contraindicators, but should be taken into account, particularly if the patient is receiving an anticholinergic by another route.
Hyoscine butylbromide, also known as scopolamine butylbromide [4] and sold under the brandname Buscopan among others, [5] is an anticholinergic medication used to treat abdominal pain, esophageal spasms, bladder spasms, biliary colic, [6] and renal colic. [7] [8] It is also used to improve excessive respiratory secretions at the end of life. [9]
As all anticholinergics, solifenacin may rarely cause hyperthermia due to decreased perspiration. [8] Somnolence (sleepiness or drowsiness) has been reported. [2] Severe allergic reactions, such as angioedema (swelling beneath the skin) and anaphylaxis, have been reported in people treated with solifenacin succinate and may be life-threatening. [2]