Avoid using anticholinergic medication to treat overactive bladder in women older than 70 years.
|Rationale and Comments:||Anticholinergic medications block acetylcholine at muscarinic receptors, which are present throughout the body. These medications have many side effects, including impaired cognition, drowsiness, and constipation. Several cohort studies have raised concern regarding an association between higher exposure to anticholinergics and increased risk of dementia. Given this, beta-3 agonists or third-line therapies should be preferentially utilized when possible. When anticholinergics cannot be avoided, the lowest effective dose of anticholinergic should be used, and consideration should be given to decreasing the dose of other concurrent anticholinergic medications.|
|References:||• AUGS consensus statement: Association of Anticholinergic Medication Use and Cognition in Women with Overactive Bladder. Female Pelvic Med Reconstr Surg. 2017;23(3):177-178.
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