Antimuscarinic: From 1 Different Sources
(anticholinergic) adj. inhibiting the action of *acetylcholine, the neurotransmitter that conveys information in the parasympathetic nervous system. Antimuscarinic drugs block the effects of certain (muscarinic) receptors (hence their name). The actions of these drugs include relaxation of smooth muscle, decreased secretion of saliva, sweat, and digestive juices, and dilation of the pupil of the eye. *Atropine and similar drugs have these effects; they are used in the treatment of gut spasms (e.g. *propantheline) and of parkinsonism (e.g. *trihexyphenidyl) as bronchodilators (e.g. *ipratropium), and as *mydriatics. Characteristic side-effects include dry mouth, thirst, blurred vision, dry skin, increased heart rate, and difficulty in urination.
A pharmacological e?ect where the action of ACETYLCHOLINE, a chemical neurotransmitter released at the junctions (synapses) of parasympathetic and ganglionic nerves, is inhibited. The junctions between nerves and skeletal muscles have nicotinic receptors. A wide range of drugs with antimuscarinic effects are in use for various disorders including PSYCHOSIS, BRONCHOSPASM, disorders of the eye (see EYE, DISORDERS OF), PARKINSONISM, and problems of the GASTROINTESTINAL TRACT and URINARY TRACT. (See also ANTISPASMODICS.)... antimuscarine
These are antimuscarinic drugs (see ANTIMUSCARINE) which have the property of relaxing smooth muscle. Along with other antimuscarinic drugs, antispasmodics may be helpful supportive treatment for patients with non-ulcer DYSPEPSIA, IRRITABLE BOWEL SYNDROME (IBS) and DIVERTICULAR DISEASE. Examples of antispasmodic drugs are ATROPINE sulphate, dicyclomine bromide and propantheline (a synthetic antimuscarinic drug used as a treatment adjunct in gastrointestinal disorders and also for controlling urinary frequency), bromide, alverine, mebervine and peppermint oil. With the arrival of more powerful and speci?c antisecretory drugs, such as the histamine H2-receptor antagonists – examples are CIMETIDINE and RANITIDINE – the use of antispasmodics has declined.... antispasmodics
One of the ANTIARRHYTHMIC DRUGS given by intravenous injection after myocardial infarction to restore supraventricular and ventricular arrhythmias to normal, particularly when patients have not responded to lidocaine (lignocaine). It can impair the contractility of heart muscle and it does have an antimuscarinic e?ect (see ANTIMUSCARINE); consequently its administration has to be undertaken with care, especially in patients with GLAUCOMA or enlargement.... disopyramide
A well-established, relatively safe tricyclic antidepressant (see ANTIDEPRESSANT DRUGS) used to treat DEPRESSION; the drug does, however, have antimuscarinic and cardiac side-effects. It is also used to treat ENURESIS by an action distinct from its antidepressant e?ect.... imipramine
These ANTIDEPRESSANT DRUGS have few antimuscarinic effects (see ANTIMUSCARINE), but do have adverse effects of their own – predominantly gastrointestinal. They are, however, much safer in overdose than the tricyclic antidepressants, which is a major advantage in patients who are potentially suicidal. Examples are citalopram, used to treat panic disorders, as well as depressive illness; FLUOXETINE; and PAROXETINE. (See also MENTAL ILLNESS.)... selective serotonin-reuptake inhibitors (ssris)
1. n. any drug that inhibits sweating, such as an *antimuscarinic drug. 2. adj. inhibiting sweating.... anhidrotic
adj. see antimuscarinic.... anticholinergic
Urinary incontinence The International Continence Society de?nes urinary incontinence as an involuntary loss of URINE that is objectively shown and is a social and hygiene problem. The elderly suffer most from this disorder because the e?ectiveness of the sphincter muscles surrounding the URETHRA declines with age. Men are less often affected than women; 20 per cent of women over 40 years of age have problems with continence. It is estimated that around three million people are regularly incontinent in the UK, a prevalence of about 40 per 1,000 adults.
Incontinence can be divided broadly into two groups: stress incontinence and incontinence due to an overactive URINARY BLADDER – also called detrusor instability – which affects one-third of incontinent women, prevalence increasing with age. Bladder symptoms do not necessarily correlate with the underlying diagnosis, and accurate diagnosis may require urodynamic studies – examination of urine within, and the passage of urine through and from, the urinary tract. However, such studies are best deferred until conservative treatment has failed or when surgery is planned.
Incontinence causes embarassment, inconvenience and distress in women, and men are reluctant to seek advice for what remains a social taboo for most people. Su?erers should be encouraged to seek help early and to discuss their anxieties and problems frankly. Often it is a condition which can be managed e?ectively at primary care centres, and quite simple measures can greatly improve the lives of those affected. STRESS INCONTINENCE is the most common cause of urinary incontinence in women. This is the involuntary loss of urine during activities that raise the intra-abdominal pressure, such as sneezing, coughing, laughing, exercise or lifting. The condition is caused by injury or weakness of the urethral sphincter muscle; this weakness may be either congenital or the result of childbirth, PROLAPSE of the VAGINA, MENOPAUSE or previous surgery. A CYSTOCOELE may be present. Urinary infection may cause incontinence or aggravate the symptoms of existing incontinence.
The ?rst step is to diagnose and treat infection, if present. Patients bene?t from simple advice on incontinence pads and garments, and on ?uid intake. Those with a high ?uid intake should restrict this to a litre a day, especially if frequency is a problem. Constipation should be treated and smoking stopped. The use of DIURETICS should be reduced if possible, or stopped entirely. Postmenopausal women may bene?t from oestrogen-replacement therapy; elderly people with chronic incontinence may need an indwelling urethral catheter.
Pelvic-?oor exercises can be successful and the insertion of vaginal cones can be a useful subsidiary treatment, as can electrical stimulation of the pelvic muscles. If these procedures are unsuccessful, then continence surgery may be necessary. The aim of this is to raise the neck of the bladder, support the mid part of the urethra and increase urethral resistance. Several techniques are available. URGE INCONTINENCE An overactive or unstable bladder results in urge incontinence, also known as detrusor incontinence – the result of uninhibited contractions of the detrusor muscle of the bladder. The bladder contracts (spontaneously or on provocation) during the ?lling phase while the patient attempts to stop passing any urine. Hyperexcitability of the muscle or a disorder of its nerve supply are likely causes. The symptoms include urgency (acute wish to pass urine), frequency and stress incontinence. Diagnosis can be con?rmed with CYSTOMETRY. Bladder training is the ?rst step in treatment, with the aim of reducing the frequency of urination to once every three to four hours. BIOFEEDBACK, using visual, auditory or tactile signals to stop bladder contractions, will assist the bladder training. Drug treatments such as CALCIUM-CHANNEL BLOCKERS, antimuscarinic agents (see ANTIMUSCARINE), TRICYCLIC ANTIDEPRESSANT DRUGS, and oestrogen replacement can be e?ective. Surgery is rarely used and is best reserved for di?cult cases. OVERFLOW INCONTINENCE Chronic urinary retention with consequent over?ow – more common in men than in women. The causes include antispasmodic drugs, continence surgery, obstruction from enlargement and post-prostatectomy problems (in men), PSYCHOSIS, and disease or damage to nerve roots arising from the spinal cord. Urethral dilatation or urethrotomy may be required when obstruction is the cause. Management is intermittent selfcatheterisation or a suprapubic catheter and treatment of any underlying cause.
Faecal incontinence is the inability to control bowel movements and may be due to severe CONSTIPATION, especially in the elderly; to local disease; or to injury or disease of the spinal cord or nervous supply to rectum and anal muscles. Those with the symptom require further investigation.... incontinence
n. a drug that prevents vomiting. Various drugs have this effect, including some *antihistamines (e.g. cyclizine, promethazine) and *antimuscarinic drugs. They are used for such conditions as motion sickness and vertigo; drugs used to counteract nausea and vomiting due to other causes (e.g. cytotoxic drugs) include *domperidone, *metoclopramide, and *ondansetron.... antiemetic
any drug that reduces the normal rate of secretion of a body fluid, usually one that reduces acid secretion into the stomach. Such drugs include *antimuscarinic drugs, H2-receptor antagonists (see antihistamine), and *proton-pump inhibitors.... antisecretory drug
n. an *antimuscarinic drug that occurs in deadly nightshade (see belladonna). Because it dilates the pupil and paralyses the ciliary muscle (see cycloplegia; mydriatic), atropine is used in eye examinations and the treatment of anterior *uveitis. It is also administered by injection to treat a slow heart rate (*bradycardia) associated with arrhythmias or, with *neostigmine, to reverse the action of muscle relaxants used during surgery. It is sometimes used to treat gut spasms and – rarely – for *premedication. Common side-effects include dryness of the throat, thirst, impaired vision, and increased heart rate.... atropine
n. an agent that causes widening of the air passages by relaxing bronchial smooth muscle. *Sympathomimetic drugs that stimulate ?2 adrenoceptors, such as *formoterol, *salbutamol, and *terbutaline, are potent bronchodilators and are used for relief of bronchial asthma and chronic obstructive pulmonary disease. These drugs are often administered as aerosols, giving rapid relief, but at high doses they may stimulate the heart. Some antimuscarinic drugs (e.g. *ipratropium and *theophylline) are also used as bronchodilators.... bronchodilator
This group of drugs is one of three main types of drugs used to treat DEPRESSION, and was the ?rst to be introduced (in the 1950s). Tricyclic drugs work by blocking the re-uptake of the neurotransmitters SEROTONIN and NORADRENALINE (see NEUROTRANSMITTER), thus increasing the amount of the neurotransmitters at the nerve cell’s receptors. In people with depression, fewer neurotransmitters than normal are released, resulting in a slowing of neural activities. The drugs have a sedative e?ect, which can be useful for depressives with sleep problems, and an antimuscarinic action which can cause dry mouth and constipation (see ANTIMUSCARINE). Overdosage can produce COMA, ?ts (see SEIZURE) and irregular heart rhythm (ARRHYTHMIA). They are sometimes used for treating bed-wetting. (See also ANTIDEPRESSANT DRUGS.)... tricyclic antidepressant drugs
n. a drug designed to alleviate the symptoms of *depression. Most antidepressants act by altering the availability of *serotonin and *noradrenaline in the brain; they are also likely to influence synaptic transmission regulation and postsynaptic conduction. There are four main classes of antidepressants. The selective serotonin reuptake inhibitors, such as fluoxetine, sertraline, escitalopram, and citalopram (see SSRI), are recommended as first-line treatment for depression and anxiety by current NICE guidelines. Their mode of action is entirely on serotonin. Side-effects include gastrointestinal problems and nausea. Tricyclic antidepressants, such as *imipramine, *doxepin, *lofepramine, *clomipramine, and *amitriptyline, are also widely used. They act on noradrenaline as well as serotonin, although most of them primarily have a noradrenergic action. They are also used in chronic pain management. Their side-effect profile varies from that of SSRIs; on the whole they have more *antimuscarinic effects and are more sedative. They are more dangerous in overdose than SSRIs and cause more weight gain. Other side-effects include postural hypotension. Serotonin and noradrenaline reuptake inhibitors), such as venlafaxine and duloxetine (see SNRI), are a common second-line choice in the treatment of depression and anxiety. Monoamine oxidase inhibitors (MAOIs), such as the reversible moclobemide and the irreversible phenelzine (see MAO inhibitor), are older antidepressants. They are now less used because of significant side-effects and interactions with other drugs. The irreversible MAOIs also require certain dietary restrictions. Antidepressants are not addictive, but depending on their half-life they show a varying prevalence of *discontinuation syndrome. Antidepressants have consistently been shown to be more effective than placebo. Their efficacy is lower in mild depression but moderate to good in moderate and severe depression. They are part of the gold-standard treatment for depression and anxiety.... antidepressant
n. any one of a group of drugs used to treat severe mental disorders (psychoses), including schizophrenia and mania; some are administered in small doses to relieve anxiety and tic disorders or to treat impulsivity in *emotionally unstable personality disorder. Formerly called major tranquillizers, and later typical and atypical antipsychotics, they are now known as first- and second-generation antipsychotics. The first-generation (or typical) antipsychotics include the *phenothiazines (e.g. *chlorpromazine), *butyrophenones (e.g. *haloperidol), and thioxanthenes (e.g. *flupentixol). Side-effects of antipsychotic drugs can include *extrapyramidal effects, sedation, *antimuscarinic effects, weight gain, and *long QT syndrome. The second-generation (or atypical) antipsychotics are a group of more recently developed drugs that are in theory associated with fewer extrapyramidal effects than first-generation antipsychotics: they include *clozapine, *risperidone, amisulpride, aripiprazole, olanzapine, and quetiapine. Antipsychotics act on various neurotransmitter receptors in the brain, including dopamine, histamine, serotonin, and cholinergic receptors. Most of them block neurotransmitter activity, but some have partially agonistic effects. Recent evidence suggests that there are significant differences among the second-generation antipsychotics regarding their efficacy and side-effect profiles. Clozapine, amisulpride, and olanzapine were found to be the most effective antipsychotics. Clozapine, zotepine, and olanzapine caused the most weight gain; haloperidol, zotepine, and chlorpromazine caused the most extrapyramidal side-effects; sertindole, amisulpride, and ziprasidone caused the most QT-prolongation; and clozapine, zotepine, and chlorpromazine caused the most sedation.... antipsychotic
n. an agent that reduces or relieves nasal congestion. Nasal decongestants are *sympathomimetic or *antimuscarinic drugs applied locally, in the form of nasal sprays or drops.... decongestant
(dicyclomine) n. an *antimuscarinic drug that reduces spasms of smooth muscle and is used as an *antispasmodic to relieve irritable bowel syndrome and related conditions. Side-effects include dry mouth, thirst, and dizziness.... dicycloverine
an *antimuscarinic drug used as a maintenance bronchodilator to relieve symptoms in adults with COPD. It is administered by inhalation; side-effects include dry mouth. Trade name: Seebri Breezhaler.... glycopyrrhonium bromide
(scopolamine) n. an *antimuscarinic drug that prevents muscle spasm. Hyoscine butylbromide is administered in the treatment of spasm in the digestive system and difficult or painful menstruation. Hyoscine hydrobromide is used for preoperative medication and to treat motion sickness. Side-effects of both drugs are rare but can include dry mouth, blurred vision, difficulty in urination, and increased heart rate.... hyoscine
(hyperidrosis) n. excessive sweating, which may occur in certain diseases, such as thyrotoxicosis or fevers, or following the use of certain drugs. More commonly, however, there is no underlying cause for this condition. There are many successful treatments, including topical preparations, antimuscarinic drugs, and injections of *botulinum toxin.... hyperhidrosis
n. an *antimuscarinic drug used as a bronchodilator in the treatment of chronic reversible airways obstruction (see bronchospasm) and to relieve rhinorrhoea resulting from *rhinitis. Side-effects include dry mouth and nasal dryness.... ipratropium
n. a tricyclic *antidepressant that is less sedating than amitriptyline and has a lower incidence of *antimuscarinic side-effects.... lofepramine
a spasmodic deviation of the eyes upwards with head tilted backwards, which may last minutes or hours. It occurs in patients with postencephalitic *parkinsonism and in patients taking phenothiazine drugs. Treatment is with antimuscarinic drugs.... oculogyric crisis
n. an *antimuscarinic drug that relieves spasm in muscle, used to treat parkinsonism induced by antipsychotic drugs. Side-effects may include dry mouth, sight disturbances, and difficulty in urination.... orphenadrine
n. an *antimuscarinic drug used to reduce frequency and urgency of passing urine associated with an instability of the *detrusor muscle of the bladder wall. It acts by reducing spontaneous detrusor activity and decreasing detrusor pressure. Side-effects include a dry mouth, loss of appetite, constipation, and blurred vision.... oxybutynin
adj. opposing the effects of the *parasympathetic nervous system. *Antimuscarinic drugs have this effect by preventing acetylcholine from acting as a neurotransmitter.... parasympatholytic
n. an *antimuscarinic drug used to reduce muscle tremor and rigidity in parkinsonism. Common side-effects include dry mouth, blurred vision, and giddiness.... procyclidine
n. an *antimuscarinic drug that decreases activity of smooth muscle (see antispasmodic) and is used to treat disorders of the digestive system and (in adults) *enuresis. Side-effects include dry mouth and blurred vision.... propantheline
n. an *antimuscarinic drug administered to relieve urinary frequency, urgency, and incontinence due to overactivity of the *detrusor muscle of the bladder. It has few side-effects.... solifenacin
n. 1. a drug that interacts with another to produce increased activity, which is greater than the sum of the effects of the two drugs given separately. Some synergists may have dangerous effects, as when MAO inhibitors enhance the effects of antihistamine and antimuscarinic drugs. 2. a muscle that acts with an *agonist in making a particular movement. —synergism n.... synergist
n. an alkaloid, occurring in the leaves of the tea plant, that has a diuretic effect and relaxes smooth muscle, especially of the bronchi (it is an *antimuscarinic drug). It is used mainly as a bronchodilator to treat severe asthma attacks. *Aminophylline is theophylline combined with ethylenediamine.... theophylline
n. an *antimuscarinic drug taken to treat *detrusor overactivity giving rise to the *lower urinary tract symptoms of frequency, urgency, or urge incontinence.... tolterodine
(benzhexol) n. an *antimuscarinic drug that is used mainly to reduce muscle tremor and rigidity in drug-induced parkinsonism. The most common side-effects are constipation, dry mouth, and blurred vision.... trihexyphenidyl
n. an *antimuscarinic drug used in the form of eye drops to dilate the pupil so that the inside of the eye can more easily be examined or operated upon.... tropicamide
an *antimuscarinic drug indicated for the treatment of overactivity of the bladder *detrusor muscle with symptoms of urge incontinence, urgency, and frequency. The most common side-effects are dry mouth and constipation.... trospium chloride
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