There is a growing epidemic in the senior community of adverse effects to anticholinergic drugs. These agents present a risk that is especially dangerous for older Americans, as seniors can be particularly sensitive to their side effects. Anticholinergic drugs have been used in medicine for several decades and are used to treat a wide range of conditions that are common among seniors, which further complicates a challenging scenario. Older adults, caregivers and loved ones can help to ensure limited negative side effects by anticholinergics by having all medications reviewed by a trusted physician and making a conscious effort to research the components of any new medications, both prescription and over-the-counter. These drugs can increase fall risk, cause drowsiness, ataxia, and several other side effects that are particularly dangerous for older adults. To ensure safety and 24/7 protection, seniors should always have a personal medical alert system, preferably with fall detection, to guarantee that they are always able to call for help in an emergency, even if they are unable to press a help button.
Anticholinergic drugs block (or "antagonize") the action of acetycholine, a neurotransmitter that is responsible for muscular contractions in the body, as well as memory and learning within the brain. The ability to reduce muscular and brain function, by blocking release of the chemical needed for nerve cells to communicate with one another, is both what makes anticholinergics highly effective for treating a diverse group of ailments and what makes this treatment choice a particular danger to older Americans. Anticholinergic drugs are often used in the treatment of diarrhea, overactive bladder, incontinence, Parkinson's disease, motion sickness, chronic obstructive pulmonary disease (COPD), insomnia, and many more ailments that are commonly experienced among seniors. This anticholinergic drug list can provide more information on some of the medications that contain anticholinergics.
The median number of prescription drugs used among American adults aged 65 and older doubled between 1998 and 2010, with the average number of medications prescribed per senior patient jumping from 2 to 4 and the percentage of older adults taking more than 5 prescriptions tripling to over 12%. Considering the significant rise in the use of anticholinergic drugs and the staggering number of multiple medications being prescribed to seniors in America, it is important to become familiar with the functions and potential cognitive impacts of these agents. Research suggests that anticholinergic toxicity becomes a more prevalent threat as humans age, meaning Americans are being prescribed the highest amount of potentially dangerous drugs during the time in their lifespan that they are most susceptible to their negative side effects.
The physical and pathophysiological changes that accompany the aging process, coupled with older patients being prescribed multiple medications to be taken in conjunction with one another, can result in pharmacokinetic and pharmacodynamic drug interactions which actually heighten anticholinergic effects. The concern over adverse effects caused by these drugs steadily increases, just as the number of prescription medications used by seniors rises. With awareness of the highly effective ability anticholinergic drugs have to impact muscle and brain function, patients of all ages should approach consuming them with caution. Operating machinery, walking up or down stairs, traveling, and all activities that require muscular ability and cognitive function have the potential to be negatively impacted by anticholinergics. These tasks should be approached carefully and with a mobile emergency alert system to guarantee help is always within reach.
Seniors, caregivers and loved ones should familiarize themselves with a few key factors about these drugs and how the work in the body to understand why they present a specific threat to older adults.
anticholinergic drugs - inhibiting the physiological action of acetylcholine, especially as a neurotransmitter.
"Anticholinergic drugs inhibit the transmission of parasympathetic nerve impulses, thereby reducing spasms of smooth muscles (for example, muscles in the bladder). Side effects of anticholinergic medications include dry mouth and related dental problems, blurred vision, tendency toward overheating (hyperpyrexia), and in some cases, dementia-like symptoms." - MedicineNet.com
pathophysiological - The functional changes associated with or resulting from disease or injury.
pharmacokinetic - a branch of pharmacology dedicated to determining the fate of substances administered to a living organism. It attempts to analyze chemical metabolism and to discover the fate of a chemical from the moment that it is administered up to the point at which it is completely eliminated from the body.
pharmacodynamic - the study of the biochemical and physiologic effects of drugs. The effects can include those manifested within animals (including humans), microorganisms, or combinations of organisms (for example, infection).
*Pharmacodynamics is the study of how a drug affects an organism, whereas pharmacokinetics is the study of how the organism affects the drug.
With a careful review of all medications taken, exploring holistic alternatives and exercising caution in consuming any new medications, seniors can minimize the threat of negative side effects from anticholinergic drugs. The ailment being treated and the potential adverse outcomes should always be considered with a trusted primary care physician.
Sources:
- https://www.healthline.com/health/anticholinergics
- https://www.ncbi.nlm.nih.gov/pubmed/8369593
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573668/
- https://www.medscape.com/viewarticle/805518_1
- https://en.wikipedia.org/wiki/Pharmacokinetics
- https://www.medicinenet.com/script/main/art.asp?articlekey=2281
- https://www.drugs.com/article/anticholinergic-drugs-elderly.html