Dispensing of anticholinergic medicines also increased following initiation of cholinesterase inhibitors.
Some of these anticholinergic medicines may have been prescribed to treat the adverse effects of the cholinesterase inhibitor (eg. Patients may benefit from clinicians reviewing the anticholinergic load of their current medicine regimen before initiating cholinesterase inhibitors or memantine, with the aim of minimising or ceasing medicines with anticholinergic properties.
Medicines specifically prescribed for their anticholinergic properties (eg.
oxybutynin, benzhexol and benztropine) are well recognised by clinicians.
Use of medicines with anticholinergic or sedative properties may result in adverse events by increasing the overall anticholinergic or sedative load.
Patients may benefit from clinicians reviewing the anticholinergic load of the current medicine regimen before the initiation of cholinesterase inhibitors or memantine.
Cholinesterase inhibitors (donepezil, rivastigmine and galantamine) may modestly improve cognition via inhibiting the enzyme acetyl cholinesterase.
Restricted supply of these medicines is subsidised through the Pharmaceutical Benefits Scheme (PBS) using the authority system for the management of mild to moderate Alzheimer disease.
In a cross sectional study of 364 people aged more than 80 years living in Italy, the use of medicines with serum anticholinergic activity was associated with poorer physical performance battery scores, reduced hand grip strength and compromised activities of daily living.In 932 community dwelling people aged more than 65 years in the Women's Health and Aging Study conducted in the United States, use of medicines with anticholinergic properties was associated with difficulties in balance and mobility.* New medicine: reported adverse effects profile is consistent with moderate anticholinergic effects ** Not included on the schedule of PBS/RPBS benefits *** Found in cold and flu treatments, may be purchased over-the-counter Reproduced from Veterans' MATES Therapeutic brief 25.Available at Medicines with sedative properties include also have sedative properties.Medicines with sedative properties have been linked to depressive symptoms, worsening cognition, respiratory depression, impaired muscle strength and falls and fractures.
All medicines with sedative properties – not only those prescribed for intentional sedation – may contribute to an older person's sedative load.removal of clutter, good lighting, nonslip flooring, ensuring the toilet is clearly marked, hand rails, raised toilet seat height and appropriate clothing).