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