Drugs with anticholinergic activity are commonly used in older people [10]. Examples are shown in the table below.
Table 1 Anticholinergic drugs
Type of drug | Example |
Antihistamine | Hydroxyzine, diphenhydramine |
Antispasmodic | Alverine, hyoscyamine |
Tricyclic antidepressant | Amitriptyline |
Benzodiazepine | Lorazepam |
Analgesic | Codeine |
Antiarrhythmic | Digoxin |
Diuretic | Furosemide |
Antiparkinsonian | Orphenadrine, benzatropine (US vs. UK) |
Bladder stabiliser | Oxybutynin |
Bronchodilator | Theophylline |
When several of these are co-prescribed, the anti-cholinergic burden (ACB) is increased and leads to greatly increased risk of adverse effects in the elderly [11].