Anticholinergic Agents

Question 1

Describe the absorption properties of Anticholinergic agents?

Answer 1

Well-absorbed by GI tract and lipophilic so easily enter CNS

Question 2

What are the peak plasma concentration times and duration of action for Artane and Cogent?

Answer 2

Peak plasma 2-3 hours and duration 1-12 hours

Question 3

Which of the anticholinergic agents also has antihistaminergic effects?

Answer 3

Cogent

Question 4

General mechanism of anticholinergics?

Answer 4

Block muscarinic acetylcholine receptors

Question 5

What are the therapeutic indications for Anticholinergics in psychiatry?

Answer 5

Neuroleptic induced parkonsonsim, neuroleptic induced acute dystonia

Question 6

Precautions with anticholinergics?

Answer 6

BPH, urinary retention, narrow angle glaucoma

Question 7

Describe the symptoms of anticholinergic intoxication?

Answer 7

Delirium, coma, seizures, agitation, hallucinations, severe hypotension, supraventricular tachycardia, and peripheral manifestations (flushing, mydriasis, dry skin, hyperthermia, and decreased bowel sounds).

Question 8

Drug interactions with anticholinergics?

Answer 8

Other drugs with anticholinergic properties such as DRA’s, TCA’s, MAOI’s.

Also delays gastric emptying so reduced absorption of DRA’s and other drugs broken down in stomach.

Question 9

What are some common side effects of anticholinergics?

Answer 9

Anticholinergics: Dry mouth, blurry vision, constipation, drowsiness, sedation, urinary retention, cognitive difficulties.

Question 10

Dosage and clinical guidelines for Cogent in Neuroleptic induced parkonsonism?

Answer 10

For the treatment of neuroleptic-induced parkinsonism, the equivalent of 1 to 3 mg of benztropine should be given one to two times daily.

The anticholinergic drug should be administered for 4 to 8 weeks, and then it should be discontinued to assess whether the person still requires the drug. Anticholinergic drugs should be tapered over a period of 1 to 2 weeks.

Question 11

Dosage and clinical guidelines for Neuroleptic induced acute dystonia?

Answer 11

For the short-term treatment and prophylaxis of neuroleptic-induced acute dystonia, 1 to 2 mg of benztropine or its equivalent in another drug should be given IM. The dose can be repeated in 20 to 30 minutes, as needed. If the person still does not improve in another 20 to 30 minutes, a benzodiazepine (e.g., 1 mg IM or IV lorazepam [Ativan]) should be given.