There are dozens of medications that have anticholinergic activity or are considered an anticholinergic medication. While most of the agents are used for their antihistamine, sedative, or antidepressant activity, There are a few uses that are unique to individual medications within this broad classification. I highlight 5 medications with unique anticholinergic indications.
Dicyclomine (Bentyl) for GI Spasms/Cramping
Dicyclomine is an anticholinergic agent that can be used to help calm down the GI tract. It is most frequently used in patients who have GI spasms and/or cramping type symptoms. These symptoms most commonly occur in patients who have been diagnosed with IBS
Both of these medications are highly anticholinergic and can be used in the management of Parkinson’s type symptoms. Because you need large doses to get benefit in Parkinson’s, these drugs are seldom used compared to the standard of Parkinson’s therapy with carbidopa/levodopa.
These drugs are also very unique in that you may see them used to help manage extrapyramidal symptoms from antipsychotics.
TCA’s for Pain
TCA’s are classically referred by their antidepressant activity. They used to be highly used until the development of the much safer/tolerable SSRI’s. They still can be used for various pain syndromes like neuropathy and fibromyalgia.
Atropine has a couple of unique uses. Atropine eye drops (given orally) have been a tool in the toolkit of hospice healthcare professionals to help reduce excessive saliva.
In addition, atropine is part of the ACLS algorithm in patients with bradycardia. Remember that anticholinergic medications can cause cardiac changes.
Organophosphate poisoning was another potential indication for atropine that I remember being tested on in school.
Motion sickness is a significant concern for many patients. Scopolamine is uniquely used for this indication.
Any others you’d like to add? Feel free to leave a comment below!
- 30 medication mistakes PDF
- 18+ Page Drug Interaction PDF
- 10 Commandments of Polypharmacy Webinar based on my experiences in clinical practice