Doctor Soneral is a resident physician with the University of Wisconsin-Madison, Department of Family Medicine. Doctor Connor is in Pediatric Critical Care Medicine at St Mary’s Hospital Medical Center, Madison, Wis. Please address correspondence to: Steven N. Soneral, DO, Department of Family Medicine, 777 S Mills St, Madison, WI 53715-1896; phone 608.263.4550; fax 608.263.5813; e-mail ssonera...

Bronchodilators provide the mainstay of pharmacologic therapy for chronic obstructive pulmonary disease (COPD), and anticholinergic bronchodilators, in particular, appear to be the most effective. There are currently two anticholinergic agents available in the US for the treatment of COPD (ipratropium bromide and tiotropium bromide), but several others are in various stages of development. Acli...

BACKGROUND Polypharmacy, potentially inappropriate medications and anticholinergic burden (as assessed by the anticholinergic risk scale) are commonly used as quality indicators of pharmacotherapy in older adults. However, their role in clinical practice is undefined. We sought to investigate longitudinal changes in these indicators and their effects on clinical outcomes. METHODS We used Taiw...

Alzheimer's disease (AD) is well known as a disease characterized by degeneration of cholinergic neuronal activity in the brain. It follows that patients with AD would be sensitive to an 'anticholinergic burden', and also that medicine with anticholinergic properties would promote various clinical symptoms of AD. Despite the relevance of this important phenomenon to the clinical therapeutics of...

OBJECTIVE While the anticholinergic activity of medications has been linked to cognitive decline, few studies have linked anticholinergic burden with falls in older people. We evaluated the relationship between anticholinergic burden and recurrent and injurious falls among community-dwelling older adults. STUDY DESIGN This case-control study was performed on 428 participants aged ≥65 years, 2...

INTRODUCTION Overactive bladder (OAB) is a prevalent condition that has a significant impact on quality of life. The usual treatment approach is both behavioral and pharmacological. The first-line pharmacological treatment commonly utilizes anticholinergic agents, which may be limited by their tolerability, efficacy, and long-term compliance. Developments in elucidating the pathophysiology of O...

INTRODUCTION Older people often use medications with anticholinergic or sedative side effects which increase the risk of falling and worsen cognitive impairment. The Drug Burden Index (DBI) is a measure of the burden of anticholinergic and sedative medications. Medication reviews are typically done by a pharmacist in collaboration with a general practitioner to optimise the medication use and r...

Overactive bladder (OAB), often accompanied by urinary incontinence, is most prevalent among the elderly, but also affects many middle-aged men and women in the US. OAB may severely impair quality of life, and its overall economic costs to society are substantial. Although antimuscarinic agents relieve OAB symptoms effectively, treatment persistence generally is low. This has been attributed in...