Website maintenance is planned from 8:00 a.m. CDT Saturday, July 27, through 9:00 p.m. CDT Sunday, July 28. Brief disruptions may occur during this time.
Many medications have strong anticholinergic activity including first generation antihistamines (e.g., diphenydramine, doxylamine), tricyclic antidepressants, gastrointestinal antispasmodics, antiemetics, muscle relaxants, medications for urinary incontinence, and medications to treat Parkinson disease. Older adults are more sensitive to adverse events associated with anticholinergics, including confusion, dry mouth, blurry vision, constipation, urinary retention, decreased perspiration, and excess sedation. Anticholinergics have also been associated with increased risk of dementia. These medications are especially problematic for people with existing cognitive impairment, and bladder anticholinergics should be used judiciously for these patients. It is important to inquire about over-the-counter antihistamine use and help patients select safer alternatives for sleep and seasonal allergies. For example, for seasonal allergies, second-generation antihistamines have minimal anticholinergic effects and allergies may be managed with inhaled steroids.