| N06D A Antikolinesteraser - G04B D08 Solifenacin |
| ATC1 | N06D A Antikolinesteraser (Anticholinesterases) |
| ATC2 | G04B D08 Solifenacin |
| Nivå | Bør ikke kombineres. (les mer...) |
| Konsekvens | Nedsatt kolinerg aktivering av kolinesterasehemmere, økt sannsynlighet for terapisvikt og risiko for delir/forvirring |
| Håndtering | Dosetilpasning: Antikolinergene urinveisspasmolytika bør generelt unngås ved demens og behandling med kolinesterasehemmere/demens.
Legemiddelalternativer: Mirabegron har ikke antikolinerge effekter. |
| Mekanisme | Urinveisspasmolytika er muskarinantagonister og kan motvirke effekten av det økte acetylkolinnivået i hjernen som kolinesterasehemmere gir. |
| Grunnlag | Kasusrapporter |
| Referanser |
| 1. | Edwards KR, et al. Risk of delirium with concomitant use of tolterodine and acetylcholinesterase inhibitors. J Am Geriatr Soc 2002;50:1165-6. Les mer... |
| 2. | Tsao JW, et al. Transient memory impairment and hallucinations associated with tolterodine use. N Engl J Med 2003;349:2274-5 Les mer... |
| 3. | Williams SG, et al. Hallucinations with tolterodine. Psychiatr Serv 2004;55:1318-9 Les mer... |
| 4. | Katz IR, et al. Identification of medications that cause cognitive impairment in older people: the case of oxybutynin chloride. J Am Geriatr Soc 1998;46:8-13 Les mer... |
| 5. | Beers MH, et al. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med 1991;151:1825-32 Les mer... |
| 6. | Roe CM, et al. Use of anticholinergic medications by older adults with dementia. J Am Geriatr Soc 2002;50:836-42 Les mer... |
| 7. | Fick DM, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003;163:2716-2724 Les mer... |
| 8. | Carnahan RM, et al. The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice? J Am Geriatr Soc 2004;52:2082-7 Les mer... |
| 9. | Han L, et al. Use of medications with anticholinergic effect predicts clinical severity of delirium symptoms in older medical inpatients. Arch Intern Med 2001;161:1099-105 Les mer... |
| 10. | Chan WY, et al. The use of anticholinergic medications in homebound elderly patients with dementia. Consult Pharm 2006;21:391-9 Les mer... |