logo
Advertisement

Anticholinergics are a class of drugs used to treat a wide range of conditions, but they can have unintended effects on the body. This drug class gets its name because it works by affecting acetylcholine, a neurotransmitter that plays a significant role in muscle movement and other functions in the body.

Advertisement

Intended Effects

Anticholinergic medications affect a wide range of body functions, including respiration, circulation, vision, and alertness. Many medications have anticholinergic effects, but in most cases, they are considered adverse reactions. A few drugs are prescribed specifically for their anticholinergic effects, to treat Parkinson's, psychiatric disorders, allergies, and respiratory disorders like COPD and asthma.

man having trouble eating because of hand tremors
Advertisement

Acetylcholine

Acetylcholine is a neurotransmitter that delivers messages to nerve cells and the brain. It plays a significant role in speeding up and slowing down functions like the movement of the skeletal and cardiac muscles. Researchers know a lot about how the nerves work in these movements, but little is known about how acetylcholine affects the central nervous system.

Acetylcholine chemical symbol
Advertisement

How They Work

Anticholinergics are competitive antagonists to acetylcholine. To deliver chemical messages, acetylcholine must bind with receptors on the organs or glands they are sent to activate. Anticholinergics block these receptors, preventing acetylcholine from binding with them. The chemical message does not get through, reducing the effects of the acetylcholine or stopping them altogether.

Anticholinergic medication pills on counter
Advertisement

Uses for Anticholinergics

Anticholinergics have many uses. Patients take them to relieve cramps in the bladder or GI tract or to prevent motion sickness, menstrual cramps, or urinating during sleep. In surgery, anticholinergics keep the heart beating normally, and they can help relieve post-surgery nausea and vomiting.

woman with menstrual cramps holding stomach on couch
Advertisement

Adverse Effects

Anticholinergics have many adverse effects centrally and peripherally. Central nervous system side effects include headache, memory problems, anxiety, and insomnia, even at low doses. People taking anticholinergics may also experience flushing, urinary retention, constipation, and diminished contraction in the muscles. These adverse effects are not life-threatening, but they can be signs that levels in the blood are elevated.

woman in bed can't sleep at 3 o'clock in the morning
Advertisement

Toxicity

Toxicity from anticholinergics usually occurs from accidental medication misuse, though it can also occur in people taking the right dose. People taking oral anticholinergics are more likely to experience toxicity. This is especially true if they are taking multiple similar medications: the effects are synergistic and have a stronger effect when taken together than they would on their own.

cropped image of woman taking medications
Advertisement

Signs of Toxicity

Physical symptoms such as flushing, dilated pupils, change in mental status, and fever are classic signs of anticholinergic toxicity. Some anticholinergics cause arrhythmias when taken in excess. People experiencing toxicity will be dry — this means they have symptoms like urinary retention, lack of sweat, and dry mouth. Central nervous system effects occur, too, including hallucinations, restlessness, staccato speech, and confusion. Some people experience jerking or seizures.

older woman looking confused at computer
Advertisement

Contraindications

Anticholinergics can be beneficial, but doctors and patients should consider the risk of adverse side effects and toxicity. There are many contraindications. Patients with dementia, COPD, and urinary incontinence may take multiple medications with anticholinergic effects and are at greater risk for toxicity.

Other conditions that are negatively impacted by anticholinergics include hyperthyroidism, glaucoma, and arrhythmias that cause the heart to beat too fast.

older man on breathing apparatus at clinic
Advertisement

Older Adults

Seniors are more sensitive to the effects of anticholinergics. They are also more likely to have conditions that require this treatment, like COPD and dementia. One study shows that the use of anticholinergics increases the risk of non-Alzheimers dementia. In this study, researchers attributed 10 percent of dementia cases to the use of anticholinergic medications.

older man looks confused, memory problems
Advertisement

Children

Children are more sensitive to anticholinergics than adults. Restlessness and irritability are common in children taking these medications, and side effects like shortness of breath can be severe. Kids taking anticholinergic medications may experience a rapid and dangerous increase in body temperature during hot weather and should be monitored closely.

little girl restless and can't sleep

Advertisement

More on Facty Health


Advertisement

Popular Now on Facty Health


Disclaimer

This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.