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Aktuelle Urologie Jun 2023
Topics: Humans; Cholinergic Antagonists; Dementia
PubMed: 37224851
DOI: 10.1055/a-1891-7208 -
Nihon Rinsho. Japanese Journal of... Mar 2016Many drugs have been reported to induce not only delirium but also cognitive impairment. Some types of drugs are reported to induce dementia, and prolonged hypotension...
Many drugs have been reported to induce not only delirium but also cognitive impairment. Some types of drugs are reported to induce dementia, and prolonged hypotension or hypoglycemia induced by overuse of antihypertensive drugs or oral antidiabetic drugs could result in dementia. Recently, taking multiple drugs with anticholinergic activity are reported to cause cognitive decline and anticholinergic burden should be avoided especially in patients with dementia. Drug-induced dementia can be prevented by avoiding polypharmacy and adhering to the saying 'start low and go slow' . Early diagnosis of drug-induced dementia and withdrawal of the offending drug is essential to improve cognitive function.
Topics: Cholinergic Antagonists; Dementia; Humans; Potentially Inappropriate Medication List
PubMed: 27025096
DOI: No ID Found -
Drugs Dec 2020Sofpironium bromide (ECCLOCK in Japan) gel is a topical anticholinergic agent developed by Bodor Laboratories and licenced to Brickell Biotech for the treatment of... (Review)
Review
Sofpironium bromide (ECCLOCK in Japan) gel is a topical anticholinergic agent developed by Bodor Laboratories and licenced to Brickell Biotech for the treatment of hyperhidrosis. The drug is designed to reduce sweating by inhibiting M3 muscarinic receptors in eccrine glands at the application site. In September 2020, sofpironium bromide gel 5% received its first approval in Japan for the treatment of primary axillary hyperhidrosis (PAH). Clinical studies are currently ongoing in the USA to assess the safety and efficacy of sofpironium bromide gel 15% in PAH. This article summarizes the milestones in the development of sofpironium bromide gel leading to this first approval for the treatment of PAH.
Topics: Bromides; Cholinergic Antagonists; Gels; Humans; Hyperhidrosis; Japan
PubMed: 33236266
DOI: 10.1007/s40265-020-01438-1 -
Skin Therapy Letter Mar 2019Hyperhidrosis is a condition characterized by excessive sweat production beyond which is physiologically necessary for thermal regulation. Affecting over 4.8% of the... (Review)
Review
Hyperhidrosis is a condition characterized by excessive sweat production beyond which is physiologically necessary for thermal regulation. Affecting over 4.8% of the United States population, studies have shown that severe primary hyperhidrosis interferes with daily activities and can be considered intolerable, negatively impacting a patient’s quality of life. Glycopyrronium tosylate is a topical anticholinergic agent that reduces sweat production by blocking the activation of acetylcholine receptors in peripheral sweat glands. In clinical trials, topical glycopyrronium tosylate, a pre-moistened cloth containing 2.4% glycopyrronium solution, was shown to be an effective, safe and non-invasive treatment for patients suffering from primary hyperhidrosis. This review examines the clinical trials of topical glycopyrronium tosylate and its role in primary hyperhidrosis. Glycopyrronium tosylate was recently US FDA-approved (as of June 2018) to manage patients with primary axillary hyperhidrosis.
Topics: Administration, Cutaneous; Cholinergic Antagonists; Clinical Trials as Topic; Glycopyrrolate; Humans; Hyperhidrosis
PubMed: 30970203
DOI: No ID Found -
Journal of Aerosol Medicine and... Aug 2023The journey of using anticholinergics in the treatment of asthma started with anticholinergic-containing plants such as Datura stramonium and Atropa belladonna, followed... (Review)
Review
The journey of using anticholinergics in the treatment of asthma started with anticholinergic-containing plants such as Datura stramonium and Atropa belladonna, followed by ipratropium bromide and continued with tiotropium, glycopyrronium, and umeclidinium. Although antimuscarinics were used in the maintenance treatment of asthma over a century ago, after a long time (since 2014), it has been recommended to be used as an add-on long-acting antimuscarinic agent (LAMA) therapy in the maintenance treatment of asthma. The airway tone controlled by the vagus nerve is increased in asthma. Allergens, toxins, or viruses cause airway inflammation and inflammation-related epithelial damage, increased sensory nerve stimulation, ganglionic and postganglionic acetylcholine (ACh) release by inflammatory mediators, intensification of ACh signaling at M1 and M3 muscarinic ACh receptors (mAChRs), and dysfunction of M2 mAChR. Optimal anticholinergic drug for asthma should effectively block M3 and M1 receptors, but have minimal effect on M2 receptors. Tiotropium, umeclidinium, and glycopyrronium are anticholinergic agents with this feature. Tiotropium has been used in a separate inhaler as an add-on treatment to inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA), and glycopyrronium and umeclidinium have been used in a single inhaler as a combination of ICS/LABA/LAMA in asthma in recent years. Guidelines recommend this regimen as an optimization step for patients with severe asthma before initiating any biologic or systemic corticosteroid therapy. In this review, the history of antimuscarinic agents, their effectiveness and safety in line with randomized controlled trials, and real-life studies in asthma treatment will be discussed according to the current data.
Topics: Humans; Muscarinic Antagonists; Tiotropium Bromide; Glycopyrrolate; Administration, Inhalation; Asthma; Cholinergic Antagonists; Adrenal Cortex Hormones; Inflammation; Bronchodilator Agents; Adrenergic beta-2 Receptor Agonists; Pulmonary Disease, Chronic Obstructive
PubMed: 37428619
DOI: 10.1089/jamp.2022.0059 -
La Revue Du Praticien Nov 2023MALE URINARY INCONTINENCE. Male urinary incontinence is a common condition that tends to increase with age and can significantly impact the quality of life. Beyond the...
MALE URINARY INCONTINENCE. Male urinary incontinence is a common condition that tends to increase with age and can significantly impact the quality of life. Beyond the clinical diagnosis made through patient history and examination, healthcare practitioners must strive to identify the underlying mechanism(s) and assess the degree of discomfort to initiate appropriate treatment. Two main types of urinary incontinence are distinguished: stress urinary incontinence, which can often benefit from pelvic floor muscle training, and urgency urinary incontinence, which typically responds to drug therapies (such as anticholinergics or β3-adrenergic agonists) and posterior tibial nerve stimulation as first-line options. Moreover, a certain number of red flags must be systematically sought to avoid missing, among other things, a urinary retention or an underlying local condition, and to identify as early as possible men requiring specialized urological care. It is also crucial for the general practitioner to discuss with the patient the various palliative approaches when necessary, such as the use of protective pads, penile sheaths, or a clamp, to improve the patient's comfort and quality of life.
Topics: Humans; Male; Quality of Life; Urinary Incontinence; Cholinergic Antagonists; General Practitioners; Urinary Retention
PubMed: 38294456
DOI: No ID Found -
Current Urology Reports Jul 2022To evaluate recent literature on combination and novel pharmacologic therapies for overactive bladder (OAB). (Review)
Review
PURPOSE OF REVIEW
To evaluate recent literature on combination and novel pharmacologic therapies for overactive bladder (OAB).
RECENT FINDINGS
Combination therapies demonstrating greater efficacy than monotherapy include combination anticholinergics, anticholinergic plus β-3 agonist, and anticholinergic with behavioral modification, percutaneous tibial nerve stimulation, or sacral neuromodulation. Promising novel therapies include new bladder selective anticholinergics, new β-3 agonists, and gabapentin. OAB is a symptom complex caused by dysfunction in the interconnected neural, muscular, and urothelial systems that control micturition. Although several therapeutic targets and treatment options exist, complete resolution is not always achieved, discontinuation rate for medical therapy is high, and few patients subsequently progress to third-line treatment options. Recent literature suggests combination therapy diversifying therapeutic targets is more effective than targeting a single pathway and novel treatments targeting additional pathways have promising results.
Topics: Cholinergic Antagonists; Electric Stimulation Therapy; Humans; Tibial Nerve; Urinary Bladder; Urinary Bladder, Overactive
PubMed: 35567657
DOI: 10.1007/s11934-022-01097-7 -
Acta Odontologica Scandinavica Aug 2023The aim was to study the association between high anticholinergic burden and hyposalivation and xerostomia among older people.
OBJECTIVE
The aim was to study the association between high anticholinergic burden and hyposalivation and xerostomia among older people.
BACKGROUND
Anticholinergic drugs have been shown to cause xerostomia and hyposalivation. Yet there are few studies on the association between anticholinergic burden and hyposalivation and xerostomia in the elderly.
MATERIAL AND METHODS
The study population consisted of community-dwelling older people ( = 321, mean age 81.6 years) from the Oral health GeMS study. Participants provided salivary samples and xerostomia was determined with a questionnaire. The baseline data were collected by interviews, oral clinical examinations and from patient records. Each participant's anticholinergic burden was determined by eight anticholinergic scales. Poisson regression models with robust error variance were used to estimate relative risks (RR) with a 95% confidence interval (CI).
RESULTS
RRs of high anticholinergic burden in anticholinergic scales for xerostomia (multiple symptoms) ranged from 1.02 to 1.68; for low unstimulated salivary flow (≤0.1 mL/min) from 1.47 to 1.67; and for low stimulated salivary flow (≤0.7 mL/min) from 0.99 to 2.07. A high anticholinergic burden according to seven out of eight scales was associated ( < .05) with hyposalivation or xerostomia.
CONCLUSIONS
A high anticholinergic burden was associated more strongly with hyposalivation (both unstimulated and stimulated) than with xerostomia.
Topics: Humans; Aged; Aged, 80 and over; Saliva; Cholinergic Antagonists; Xerostomia; Oral Health; Surveys and Questionnaires
PubMed: 36628441
DOI: 10.1080/00016357.2023.2166105 -
Praxis Feb 2018
Review
Topics: Age Factors; Cholinergic Antagonists; Combined Modality Therapy; Tibial Nerve; Transcutaneous Electric Nerve Stimulation; Treatment Outcome; Urinary Bladder, Overactive
PubMed: 29486647
DOI: 10.1024/1661-8157/a002901 -
Revue Medicale Suisse Sep 2019
Topics: Cholinergic Antagonists; Dementia; Humans; United Kingdom
PubMed: 31553541
DOI: No ID Found