ANTICHOLINERGIC BURDEN IN AGING PATIENTS AND ITS ROLE IN THE DEVELOPMENT OF BLADDER DECOMPENSATION

Authors:

Abstract:

Anticholinergic load is considered as a cumulative effect of medicine with anticholinergic activity. The article presents data of the role of anticholinergic load in the development of bladder decompensation in patients with benign prostatic hyperplasia. 381 patients with benign prostatic hyperplasia in the stage of subcompensation and decompensation of the bladder were examined. Anticholinergic load in elderly patients can develop both as a result of taking drugs with high potential anticholinergic activity and as a result of long-term use of drugs with low potential anticholinergic activity. Medicine with high potential anticholinergic activity reduce the symptoms of overactive bladder in patients with benign prostatic hyperplasia, but anticholinergic load becomes a deepening factor in the decompensation of bladder, which worsens the results of surgical treatment.

Keywords:

benign prostatic hyperplasia anticholinergic load low-potential anticholinergic activity high-potential anticholinergic activity bladder decompensation

References:

1. Savchenko RB. Kumulyatyvnyy kholinolitychnyy efekt v klinichniy praktytsi. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2021;21(1):188–93. [in Ukrainian]. doi:10.31718/2077-1096.21.1.188.
2. Arens AM, Kearney T. Adverse effects of physostigmine. J. Med. Toxicol. 2019;15:184–91. doi: 10.1007/s13181-019-00730-1.
3. Bishara D, Scott C, Stewart R, Taylor D, Harwood D, Codling D, et al. Safe prescribing in cognitively vulnerable patients: the use of the anticholinergic effect on cognition (AEC) tool in older adult mental health services. BJPsych bulletin. 2020;44(1):26–30. doi: 10.1192/bjb.2019.43
4. Broderick ED, Metheny H, Crosby B. Anticholinergic Toxicity. StatPearls Publishing. 2021.
5. Burkhard FC. Bosch JLHR, Cruz F, Lemack GE, Nambiar AK, Thiruchelvam N, et. al. EAU Guidelines on Urinary Incontinence in Adults. Edn. presented at the EAU Annual Congress Amsterdam, 2020.
6. Duran CE, Azermai M, Vander Stichele RH. Systematic review of anticholinergic risk scales in older adults. European journal of clinical pharmacology. 2013,69(7):1485–96. doi: 10.1007/s00228-013-1499-3
7. Fusco F, Creta M, De Nunzio C, Iacovelli V, Mangiapia F, Marzi VL, et al. Progressive bladder remodeling due to bladder outlet obstruction: a systematic review of morphological and molecular evidences in humans. BMC urology. 2018;18(1):1–11. doi: 10.1186/s12894-018-0329-4
8. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, et al. 2019 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 37th Annual Report, Clinical Toxicology. 2020;58(12):1360–541. doi: 10.1080/15563650.2020.1834219
9. Hall RCW, Chapman MJ. Anticholinergic syndrome: presentations, etiological agents, differential diagnosis, and treatment. Clinical Geriatrics. 2009;17(11):22–8.
10. Jacquia F, Kisby C, Wu JM, Geller EJ. Impact of anticholinergic load on bladder function. International Urogynecology Journal. 2015;26(4):545–9.
11. Longo VG. Behavioral and electroencephalographic effects of atropine and related compounds. Pharmacological Reviews. 1966;18(2):965–96.
12. Oros MM. The use of parenteral forms of ipidacrine in the treatment of the central and peripheral nervous system diseases. International neurological journal. 2018; 100(6):23–6.
13. Rasimas JJ, Sachdeva KK, Donovan JW. Revival of an antidote: bedside experience with physostigmine. Toxicology Communications. 2018; 2(1):85–101.
14. Remillard AJ. A pharmacoepidemiological evaluation of anticholinergic prescribing patterns in the elderly. Pharmacoepidemiology and drug safety. 1996;5(3):155–64. doi:10.1002/(SICI)1099-1557(199605)5:3<155::AID-PDS196>3.0.CO;2-D
15. Verma S, Kumar A, Tripathi T, Kumar A. Muscarinic and nicotinic acetylcholine receptor agonists: current scenario in Alzheimer's disease therapy. Journal of Pharmacy and Pharmacology. 2018;70(8):985–93. doi: 10.1111/jphp.12919

Publication:

«World of Medicine and Biology» Vol. 18 No. 81 (2022) , с. 138-142
УДК 616.62-008.46-033.1-06:616.65-007.61]-02:615.217.3

DOI:

https://doi.org/10.26724/2079-8334-2022-3-81-138-142