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|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.
|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.||URI:||http://hdl.handle.net/10316/101138||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
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