Anticholinergic drugs are chemicals that interfere with the action of Acetylcholine. They normally do this by blocking the receptors that acetylcholine normally activates. That way less of the acetylcholine acts on the receptors before it is broken down.

These drugs have many medical uses, some specifically because of the fact that they are anticholinergic and some for completely other reasons.

Atropine is used to treat some heart conditions, and for pupil dialation. It is also the primary remedy for VX and some other types of Nerve Gas.

Cyclobenzaprine (aka Flexoril) is used as a muscle relaxant, often for back spasms.

Dramamine is used to combat motion sickness, and diphenhydramine is used as an antihistamine (over the counter allergy remedy and used in sleeping pills).

Overdoses of these drugs (or rather large doses, some people do this on purpose, thus its wrong to say its an overdose) have been known to induce vivid hallucinations and last up to 24 hours. Users are often left unable to tell fantasy from reality. One of the most insidious aspects of this is that this portion of the effect normally manifests itself after more than 6 hours, when a naive user would believe that he was coming down and back to normal. (This of course depends on dose, route of administration and what chemical).

Datura, or jimson weed, contains atropine and scopolamine. Often unsuspecting people will smoke it, expecting to get high, and either die or end up in mental institutions.

Belladonna or "Deadly Nightshade" is another well known plant wich contains atropine. It was used in some places (notably Italy) by women to dialate their pupils, because this was said to make them more attractive. It was also said to have been used by witches.

Anticholinergics are medications that are commonly used before surgery to decrease the amount of secretions, such as saliva, that is produced while the patient is unconscious. They are also used to treat excessively slow heartbeats, alleviate the shaking and twitching associated with Parkinson's disease, and decrease the pressure inside the eyeball. Additionally, they are nerve agent antidotes. They block some of the actions of acetylcholine at muscarinic receptor sites.

Anticholinergics/antimuscarinics

Brand/Generic Drug Names

atropine, cyclopentolate, glycopyrrolate, homatropine, hyoscyamine, propantheline, scopolamine, tropicamide
Common uses
decrease motility in gastrointestinal, biliary and urinary tracts, decrease gastric secretions, decrease involuntary movements in Parkinson’s disease, bradydysrhythmias, nausea and vomiting, cycloplegic mydriatics
Pharmacology
inhibit muscarinic actions of acetylcholine at receptor sites in the autonomic nervous system
Class contraindications
narrow-angle glaucoma, myasthenia gravis, gastrointestinal or genitourinary obstruction
Class precautions
elderly, pregnancy, lactation, prostatic hypertrophy, congestive heart failure, hypertension, high environmental temperature
Interactions
Decreased effect: phenothiazines, levodopa
Increased anticholinergic effect: MAOIs, tricyclic antidepressants, amantadine
Adverse Reactions
dry mouth, constipation, urinary retention, urinary hesitancy, headache, dizziness, paralytic ileus
Additional Information
Assess for urinary retention, hesitancy, constipation, intake and output
Assess for tolerance
Assess mental status (affect, mood, central nervous system depression)
Administer parenteral dose with patient recumbent, keep in bed for 1 hr after dose, monitor vital signs for postural hypotension
Administer with meals to prevent gastrointestinal upset
Provide drinks, hard candy to relieve dry mouth
Evaluate therapeutic response: decreased secretions, absence of nausea and vomiting
Date of most recent Update
August 06, 2002
Further information is available in the writeup for the specific name(s) of this medication class

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