Pregled dostupnih skala za procjenu opterećenja aritikolinergičkim lijekovima

Anticholinergic medications are frequently used by older adults. They act on muscarinic acetylcholine receptors and antagonise the effects of acetylcholine by competitively binding to these receptors. Usually, they are used to manage a wide range of clinical conditions, including urinary frequency, urgency and incontinence, irritable bowel syndrome, depression, psychosis, chronic obstructive pulmonary disease and Parkinson's disease. Unfortunately, simultaneously they are associated with a wide range of adverse effects to which elderly patients are particularly sensitive. Most common adverse effects include 1dry mouth, constipation, urinary retention, falls, blurred vision and delirium. Anticholinergic burden refers to the cumulative effect of taking multiple medications with anticholinergic effects. Over the past few decades many scales have been developed to measure anticholinergic burden. These scales usually rank the anticholinergic activity of medications into 3-5 levels, ranging from no anticholinergic activity (O) to definite anticholinergic activity (3 to 5). There is high variability in existing scales; there is still no consensus on the definition, and both the number and ranking of the anticholinetgic medications listed vary considerably between the scales. Also, some scales consider the impact of different routes of administration when ranking the anticholinergic activity of medications, while others exclude topical, ophthalmic, and inhaled preparations. Future imperative is developing of one reference composite anticholinergic scale which would be a useful tool for clinicians to identify medications with anticholinergic activity