Please use this identifier to cite or link to this item:
Title: Association between anticholinergic burden and anticholinergic adverse outcomes in the elderly: Pharmacological basis of their predictive value for adverse outcomes
Authors: Lavrador, Marta 
Castel-Branco, M. Margarida 
Cabral, Ana C. 
Veríssimo, Manuel T. 
Figueiredo, Isabel V. 
Fernandez-Llimos, Fernando 
Keywords: Cholinergic antagonists; Anticholinergic effects; Aged; Risk assessment; Reproducibility of results; Chemical compounds studied in the article; Trospium chloride; Atropine; Oxybutynin; Amitriptyline; Darifenacin; Citalopram; Digoxin; Diazepam; Furosemide; Clozapine
Issue Date: Jan-2021
Publisher: Elsevier
Project: info:eu-repo/grantAgreement/FCT/POR_CENTRO/SFRH/BD/123678/2016/PT/Quantificação da carga anticolinérgica como preditor do aparecimento de resultados clínicos negativos no idoso – um contributo para a prática clínica 
info:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID/DTP/04138/2019/PT/Research Institute for Medicines 
Serial title, monograph or event: Pharmacological Research
Volume: 163
Abstract: The use of anticholinergic drugs and other drugs with anticholinergic activity is highly prevalent in older people. Cumulative anticholinergic effects, known as anticholinergic burden, are associated with important peripheral and central adverse effects and outcomes. Several methods have been developed to quantify anticholinergic burden and to estimate the risk of adverse anticholinergic effects. Serum anticholinergic activity (SAA) and anticholinergic burden scoring systems are the most commonly used methods to predict the occurrence of important negative outcomes. These tools could guide clinicians in making more rational prescriptions to enhance patient safety, especially in older people. However, the literature has reported conflicting results about the predictive ability of these tools. The majority of these instruments ignore relevant pharmacologic aspects such as the doses used, differential muscarinic receptor subtype affinities, and blood-brain barrier permeability. To increase the clinical relevance of these tools, mechanistic and clinical pharmacology should collaborate. This narrative review describes the rational and pharmacological basis of anticholinergic burden tools and provides insight about their predictive value for adverse outcomes.
ISSN: 1043-6618
DOI: 10.1016/j.phrs.2020.105306
Rights: openAccess
Appears in Collections:FFUC- Artigos em Revistas Internacionais
FMUC Medicina - Artigos em Revistas Internacionais
I&D ICBR - Artigos em Revistas Internacionais

Show full item record


checked on Nov 17, 2022


checked on May 2, 2023

Page view(s)

checked on Sep 25, 2023


checked on Sep 25, 2023

Google ScholarTM




This item is licensed under a Creative Commons License Creative Commons