Anticholinergic Drugs

Nursing Knowledge

Anticholinergic Drugs

Anticholinergic medications are a class of drugs that block the action of acetylcholine, a neurotransmitter of the parasympathetic nervous system. These drugs are commonly used in clinical practice to treat a variety of conditions like overactive bladder, chronic obstructive pulmonary disease (COPD), and motion sickness. However, they can also cause a range of side effects, particularly in older adults, and should be used with caution in certain patient populations.

Last updated: December 15, 2025

What are anticholinergics?

Anticholinergic medications are a group of drugs that block the action of acetylcholine, a neurotransmitter that transmits signals in the nervous system.

These medications target the cholinergic system, which is involved in a wide range of functions including muscle movement, heart rate, digestion, salivation, and other processes. Anticholinergics work by blocking the muscarinic acetylcholine receptors, thereby inhibiting parasympathetic nerve impulses. This can have a variety of effects on the body, depending on the specific drug and dosage.

How do anticholinergics work?

When acetylcholine binds to muscarinic receptors, it leads to various physiological responses such as muscle contraction, heart rate reduction, increased secretions, etc. By blocking these receptors, anticholinergic medications inhibit these actions. This results in various therapeutic effects, depending on where the receptors are located.

In the lungs: bronchodilation
In the gastrointestinal tract: reduce motility and secretions
In the urinary tract: decrease bladder muscle contractions
In the eyes: pupil dilation
In the heart: increase heart rate

What are the receptor locations of anticholinergic medications?

Anticholinergic medications primarily target muscarinic acetylcholine receptors. Receptor locations:

Eyes
Heart
Lungs
GI tract
Sweat glands
Urinary bladder

List of common anticholinergic drugs and their therapeutic uses

Anticholinergic medications are a diverse group, used to treat a variety of conditions. Here are some common examples:

Atropine: for bradycardia, reduce salivation and bronchial secretions during surgery, and as an antidote for organophosphate poisoning
Oxybutynin: bladder relaxant (for overactive bladder)
Ipratropium (inhaled anticholinergics): used in inhaler form for bronchodilation (COPD, asthma)
Scopolamine: for motion sickness and postoperative nausea and vomiting
Solifenacin: bladder relaxant (for overactive bladder)

What are the potential side effects of anticholinergic medications?

Table: Anticholinergics side effects

Medication	Side effects
Atropine	Blurry vision/dry eyes, dry mouth, tachycardia/palpitations, constipation
Oxybutynin	Blurry vision/dry eyes, urinary retention, constipation, H/A
Ipratropium	Confusion/dizziness, dry mouth, urinary retention, constipation, N/V
Scopolamine	Confusion/dizziness, dry mouth, sweating, sore throat
Solifenacin	Dry mouth, urinary retention, N/V, bladder pain, cloudy urine

Which clients should not be given anticholinergic medications?

Anticholinergics should be avoided in clients with:

Myasthenia gravis
Glaucoma
Tachycardia, HTN
Increased age
Hyperthyroidism
Heart failure
Severe dry mouth/constipation
Liver disease
Enlarged prostate
Hiatal hernia

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