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Disorders of the nervous system
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
Those taking drugs (commonly muscle relaxants, immunosuppressants or antimuscarinics) should have their medication reviewed for a potential effect on a fetus and perhaps change or modify their drugs before pregnancy (Ferrero, et al., 2006).
Cholinergic Antagonists
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Vishal S. Gulecha, Manoj S. Mahajan, Aman Upaganlawar, Abdulla Sherikar, Chandrashekhar Upasani
It is a newer antimuscarinic drug developed to treat overactive bladder in which there is an increased frequency of micturition and urgency and leakage. Tolterodine is equipotent with oxybutynin on muscarinic receptors of the urinary bladder, but it is shown to possess less affinity for salivary gland when compared to oxybutynin (Abrams, 1998). A 5-hydroxymethyl metabolite of tolterodine, generated after metabolism by CYP2D6, possesses comparable activity to the parent drug (Hardman and Limbird, 1996).
Case 39
Published in Edward Schwarz, Tomos Richards, Cases of a Hollywood Doctor, 2019
Edward Schwarz, Tomos Richards
In this case, there is a high suspicion of a tricyclic antidepressant overdose due to the ECG changes and the seizure activity. This can cause antimuscarinic effects such as tachycardia, blurred vision, dry mouth and urinary retention. Patients may go on to develop hypotension and arrhythmias and so cardiac monitoring is essential. Life-threatening events tend to occur within the first 6 hours of ingestion.
Gastroparesis syndromes: emerging drug targets and potential therapeutic opportunities
Published in Expert Opinion on Investigational Drugs, 2023
Le Yu Naing, Matthew Heckroth, Prateek Mathur, Thomas L Abell
Antiemetic agents are often used in conjunction with prokinetic agents to treat the symptoms of GpS. Treatment with antiemetics aims to improve nausea and vomiting but does not result in improved gastric emptying or symptoms related to delayed gastric emptying as prokinetics do. In addition to those mentioned previously, other commonly used classes of antiemetic drugs include antihistamines and antimuscarinics. Antihistamines work by blocking histamine (H1) receptors in the CNS, including the area postrema and vomiting center of the vestibular nucleus. Antimuscarinics block the action of acetylcholine at muscarinic receptors (M1) in the same sites. The histamine receptor antagonists also carry central antimuscarinic activity, which further contributes to their antiemetic effects.
Sacral neuromodulation for the treatment of overactive bladder: systematic review and future prospects
Published in Expert Review of Medical Devices, 2022
Sam Tilborghs, Stefan De Wachter
Unfortunately, current medications often have limited long-term efficacy, resulting in incomplete resolution of OAB symptoms [14]. Most patients cited multiple reasons for their discontinuation of OAB medication with a mean of 2.3 reasons. The most common reasons were ‘didn't work as expected’ (46.2%), ‘side effects’ (21.1%), ‘cost’ (17.2%), and ‘another medication/medical condition required me to stop’ (11.2%) [15]. Most common adverse effects of antimuscarinics are dry eyes, blurred vision, dry mouth, and constipation. Constipation alone may lead to the discontinuation of medication in up to 50% of patients [16]. 35% of patients will never have their medication prescription refilled due to lack of efficacy, intolerable adverse events and/or costs [17]. Compliance rates at 1 year can be as low as 18% [18].
Impact of chronic medications in the perioperative period: mechanisms of action and adverse drug effects (Part I)
Published in Postgraduate Medicine, 2021
Ofelia Loani Elvir-Lazo, Paul F White, Hillenn Cruz Eng, Firuz Yumul, Raissa Chua, Roya Yumul
Antimuscarinic drugs are generally nonselective blocking drugs, and the physiological effects are not limited to the pulmonary system. Common adverse effects of antimuscarinic drugs include bronchitis, sinusitis, headaches, dizziness, dyspepsia, nausea, xerostomia, and urinary tract infection, mydriasis, and visual accommodation. Caution should be exercised when administering antimuscarinic drugs to patients with a known history of paradoxical bronchospasms. Other common adverse effects include tachycardia, urinary retention, and constipation [44]. Other examples of drugs with prominent anticholinergic side effects include doxepin chlorpheniramine, oxybutynin, propiverine, tizanidine, ipratropium, carbamazepine, methocarbamol, tizanidine, brompheniramine, chlorpromazine, and scopolamine.