Geriatric Quick Consult      Medications to Avoid in the Elderly      Don't #3

Don't prescribe anticholinergic drugs, especially to patients with delirium, dementia, constipation, or prostatic hypertrophy.
Knowledge Action
Commonly used drugs with moderate to high anticholinergic properties

Anticholinergic medications are particularly problematic for the elderly.

They can cause sedation, blurred vision, urinary retention, confusion, hallucinations, dry mouth and constipation.

Anticholinergic agents are generally not well tolerated in elderly patients and should be avoided whenever possible.

Patients with delirium, dementia, constipation, and BPH are particularly at risk of anticholinergic adverse drug events.

In the hospital, do not start anti-cholinergic drugs unless clearly needed, and with no reasonable alternative.

In the hospital, suspend use of any anticholinergic drugs given as an outpatient, unless clearly needed for ongoing management.1
  • Avoid anticholinergic medications whenever possible.


  • Suspend use of anticholinergic meds given as outpatient.

References:

  1. Semla TP, Beizer JL, Higbee MD. Geriatric Dosage Handbook, 8th edition. Hudson (Cleveland): Lexi-Comp Inc., 2003.
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