You may be taking medication for allergies, asthma, frequent urination, or motion sickness. While the medications for each condition are different, most of these medications belong to the same large class of drugs. That's the class of drugs we're going to talk about today. They're called anticholinergics. You may not have heard of this name, but you're probably already taking one of these types of drugs.
Simply put, what are these anticholinergic drugs?
To understand this, let's first talk about a little bit about our body's nervous system. The nerve cells in our body exchange messages with each other, like a postman delivering letters. We call the chemicals that carry these messages neurotransmitters. One such special messenger is acetylcholine .
It works primarily in a part of our Autonomic Nervous System. It's called the Parasympathetic Nervous System. Although the name sounds a bit complicated, its job is very simple. It's what prepares our body to "Rest and Digest." That means things like calming our heart rate, secreting saliva and digestive juices, and controlling bladder function.
Now, what Anticholinergic drugs do is they interfere with the work of that messenger called Acetylcholine. That is, they block it. Then some of the processes that help you "rest and digest" are reduced a little. This is very useful for us in some medical conditions.
What kind of diseases are these medicines used for?
There are over 600 drugs with anticholinergic properties. This is the main action of some drugs. It can also be a side effect of others. Let's see what are the main uses of these drugs.
| Name of the drug (example) | Mainly used cases |
|---|---|
| Atropine | As a treatment for abnormally slow heart rate (bradycardia) and some poisonings. |
| Benztropine, Trihexyphenidyl | To control symptoms such as tremors caused by Parkinson's disease. |
| Diphenhydramine | It is contained in many allergy pills and some sleeping pills. |
| Ipratropium, Tiotropium | It is contained in inhalers used for respiratory diseases such as asthma and COPD. |
| Oxybutynin, Solifenacin, Tolterodine | It is also used as a cream to control frequent urination (Urge Incontinence) and bladder muscle contractions. It also comes as a cream to treat excessive sweating (Hyperhidrosis). |
| Scopolamine | It is given for nausea and vomiting that occur when traveling (motion sickness). |
| Glycopyrrolate, Vecuronium | It is used to reduce salivation before surgery and to paralyze muscles during surgery. |
In addition, some medications for depression, psychiatric medications, and some allergy medications (antihistamines) may also have this anticholinergic property as a side effect.
What are the benefits and side effects of this type of medication?
Advantages
These drugs have many uses. Sometimes they are life-saving . For example, when a poison such as insecticide is ingested, a drug called Atropine is given as a treatment. This medicine also helps to restore the heart rate when it drops dangerously low.
Important: If someone ingests a poison, immediately take the patient to the nearest hospital Emergency Treatment Unit (ETU). It is also important to call the National Poisons Information Centre at the Colombo National Hospital for more information.
On the other hand, this medicine also helps to improve the quality of our lives. Imagine, how great it is for someone who used to avoid going on a trip because they were afraid of vomiting, to be able to take a small pill and go on that trip without any problems? Similarly, this medicine helps someone who used to be afraid to go to the toilet frequently, to live a normal life.
Side Effects
Like any medicine, these anticholinergic drugs can cause side effects. However, not everyone gets them, and they can vary depending on the dose, the person's age, and other medical conditions. Older people are especially likely to experience these side effects.
Here's a little trick to remember these side effects:
- "Hot as a hare" - Increased body temperature.
- "Blind as a bat" - The pupils of the eyes become dilated, causing blurred vision.
- "Dry as a bone" - decreased production of saliva and tears.
- "Red as a beet" - Reddening of the skin.
- "Mad as a hatter" - confusion, memory problems.
| Common side effects | A simple explanation |
|---|---|
| Dry Mouth | Discomfort caused by decreased saliva production. |
| Blurred Vision | Difficulty seeing near due to enlarged pupil. |
| Inability to pass urine (Urinary Retention) | Difficulty completely emptying urine due to relaxation of the bladder muscles. |
| Constipation | Slowing down of digestive processes. |
| Confusion/Dementia | It can occur especially in older people. |
| Rapid heartbeat (Tachycardia) | Feeling of increased heart rate. |
When should I see a doctor?
If you are using this type of medication, be sure to talk to your doctor in the following situations:
- If the medicine you are taking does not bring you the desired relief.
- If you have difficulty using the medicine exactly as prescribed by the doctor.
- If the side effects of the medication are interfering with your daily activities (for example, if you have difficulty eating because of dry mouth, or if you have difficulty driving or reading a book because of blurred vision).
Most importantly, never stop taking any medication or change the dosage without first consulting your doctor. Doing so may make your condition worse.
If you have any questions about these medications, don't be afraid to ask your family doctor. He or she can explain which treatment is best for you, its benefits, and its side effects.
Take-Home Message
- Anticholinergics are a common class of medications used to treat a variety of conditions, including allergies, asthma, Parkinson's disease, and urinary problems.
- These work by blocking the action of a chemical messenger called acetylcholine in the body's nervous system.
- Side effects such as dry mouth, blurred vision, constipation, and confusion may occur. This risk is especially high in the elderly.
- Never stop taking any medication or change the dosage without medical advice.
- If you have any concerns about your medication or its side effects, the best person to talk to is your doctor.


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