33
Anticholinergic agents
Learning objectives
Upon completion of the chapter, you should be able to:
1.
Define anticholinergic agents.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions and important drug–drug interactions of anticholinergic agents.
3.
Discuss the use of anticholinergic agents across the lifespan.
4.
Compare and contrast the prototype drug atropine with other anticholinergic agents.
5.
Outline the care considerations, including important teaching points, for people receiving anticholinergic
agents.
Glossary of key terms
anticholinergic:
drug that opposes the effects of acetylcholine at acetylcholine receptor sites
belladonna:
a plant that contains atropine as an alkaloid; used to dilate the pupils as a fashion statement in the past; used in herbal
medicine much as atropine is used today
cycloplegia:
inability of the lens in the eye to accommodate to near vision, causing blurring and inability to see near objects
mydriasis:
relaxation of the muscles around the pupil, leading to pupil dilation
parasympatholytic:
lysing or preventing parasympathetic effects
Test your current knowledge of anticholinergic agents with a PrepU Practice Quiz!
ANTICHOLINERGIC AGENTS/
PARASYMPATHOLYTICS
atropine
cyclopentolate
glycopyrrolate
hyoscine
hyoscyamine
ipratropium
propantheline
tiotropium
D
rugs that are used to block the effects of acetylcho-
line are called
anticholinergic
drugs. Because this action
lyses, or blocks, the effects of the parasympathetic
nervous system, they are also called
parasympatholytic
agents. This class of drugs was once very widely used
to decrease gastrointestinal (GI) activity and secretions
in the treatment of ulcers and to decrease other para-
sympathetic activities to allow the sympathetic system
to become more dominant. Today, more specific and less
systemically toxic drugs are available for many of the
conditions that would benefit from these effects. There-
fore this class of drugs is less commonly used. Atropine
is the only widely used anticholinergic drug. Box 33.1
discusses the use of anticholinergics across the lifespan.
ANTICHOLINERGICS/
PARASYMPATHOLYTICS
Anticholinergic agents include atropine (generic), cyclo-
pentolate (
Cyclogyl
), glycopyrrolate (
Robinul
), hyoscine
(also known as scopolamine;
Buscopan
), hyoscyamine
(
Donnatab
) (not available in New Zealand),
ipratropium
