Do you need this or any other assignment done for you from scratch?
We assure you a quality paper that is 100% free from plagiarism and AI.
You can choose either format of your choice ( Apa, Mla, Havard, Chicago, or any other)
NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.
NB: All your data is kept safe from the public.
Introduction
The elderly patients are susceptible to various drug reactions and infections. Indicatively, the anticholinergic burden has been observed within these elderly patients. Particularly, this is with regard to cognition as well as fall. A lot of research and extensive investigations in this field are eminent (Aizenberg, Sigler & Weizman et al. 2002, pp. 309). However, the persistence of the health challenge amongst the elderly patients still remains notable. This implies the need for additional and more robust investigations in this particular medical field. Anticholinergic burden may also be referred to as the cholinergic burden or pain.
Basically, it refers to an important concept in the assessment of drugs. This examination is always done to determine their feasible contribution to some predominant medical presentations. These conditions might include delirium, hallucinations or minute memory challenges. Apart from these, there might be challenges associated with urinary retention as well as the problem of tachycardia. Further investigation and analysis in this medical field is appropriate. According to most empirical surveys, the elderly population is increasingly exposed to health complications (Bain 2012, pp. 8). This is despite their increasing level of significance within the general society. This paper presents a systematic review of the effects of anticholinergic burden within elderly patients with regard to cognition and/ or fall.
The Common Anticholinergic Effects among Elderly Patients
Several drugs depict the anticholinergic properties. Most investigations have elicited vital indications. For instance, an effective correlation of the anti cholinergic experiment outcomes and how the H2 receptor blockers initiate confusion have been indicated. Confusion has been associated with a variety of complications and effects of the drugs. The elderly patients are observed to develop mild and potentially severe mental confusion (Hilmer Mager & Simonsick et al. 2007, pp. 786). Particularly, this is observed to transpire after the consumption of these drugs by the elderly persons. Trospium is associated with such high rate of confusion amongst the patients that have been put under strict investigations. The concept of controlled clinical trials and cohort studies include some of the approaches that have occasionally been applied in studying the effects of anticholinergic, drugs within the elderly patients. The issues of non-compliance to drugs have emanated as some of the potential challenges incurred during the processes of investigation. Apart from this, human confounding factors are observed to play a great role of determining the eventual outcome of experiential results.
In order to understand the potential effects of these anticholinergic drugs, their therapeutic properties and capacities must be assessed. In addition, these vital properties must also be comprehensively understood by the medical or research staff or personalities. Certain types of antipsychotics applied in the elderly patients are related to reduce risk of obtaining most critical conditions. For instance, it may lower the incidences of extrapyramidal symptoms (EPS) (Blazer, Federspiel & Ray et al 1983, pp. 33). Similarly, the minimized risk is also observed in the case of tardive dyskinesia. However, it should be indicated that a considerable number of the typical antipsychotics have the potential to cause some potentially dangerous effects. These are usually notable in the elderly and they appear as anticholinergic effects. The emergence of these side effects is normally notable after the consumption of these drugs by the elderly patients.
Observably, the consequences of the peripheral as well as anticholinergic effects are notable. For example, it is notable that these side effects might lead into the development of physical as well an s mental retardation or impairment (Jackson, Jansen & Mangoni 2009, 78). These effects are frequently associated with the elderly patients. There is need for great and inclusive awareness on the potential medications with a potential to result into the anticholinergic effects. Apart from this, there is also an emergent need to enhance proper management of the notable symptoms. These observations can adequately or sufficiently assist most clinicians engaged in the treatment of patients. Particularly, this is associated with the elderly patients who require antipsychotic therapy. Although these antipsychotics may be very effective, they have the potential risk of leading to severe complications. These complications might include examples like the extrapyramidal side effects (EPS) (Bowles 2008, pp. 91). The other effects might be of tardive dyskinesia nature.
It is imperative to note that the power of these antipsychotics anticholinergic features might bear a direct association with their tendency to result into EPS. Of course this is in relation to the critical observation of the drug action within the elderly patients. For instance, it might be noted that several typical antipsychotics possess feeble anticholinergic properties (Kasper & Resinger 2003, pp. 35). Due to this observable property, they have or depict a low capacity to cause the effect associated with the EPS condition. Particular normally applied antipsychotics may depict diverse capacities or tendencies to cause the anticholinergic effects in the elderly patients. However, they are largely linked to the reduced cases or instances of EPS.
It is vital to note that this important observation also relates to the case of tardive dyskinesia (Katlic 2011, pp. 67). Generally, this notable trend is purely the opposite of what is observed in the action of most conventional agents. It is indicated that the stronger the characteristics of most anticholinergic agent, the more probable that an elderly patient might develop the severe effects. However, this observation depends on many factors. One of the most important factors may include the level or amount of consumption of the drug by the elderly patient. The anticholinergic effects have the potential to make the elderly patients suffer from severe medical complications (Talbott, Halesk & Yudofsky et al 1988, pp. 52). The relevant clinicians must be keen to note the detrimental effects and potentials possessed by certain drugs. These potential tendencies might be important in causing the anticholinergic effects.
The need to research on and execute effective treatment and therapeutic methodologies in the management of this condition is very important. As observed within the elderly populations, these anticholinergic effects have the capacity to result into the physical and mental impairment (FERNANDEZ & RUIZ 2006, pp. 12). Usually, these indications and side effects might be disregarded to be just temporary, minimal effects related to the normal medication. Moreover, they might also be merely associated with the elderly patients prior condition. However, it is notable that the anticholinergic effects have severe implications and effects on the cognitive and mental capacities of the elderly patients. There are studies that have indicated these observations amongst the elderly populations. For instance, a particular survey analyzed the adverse occurrences and reports recorded for a period of four years. This was done by specialized clinicians.
Enrolled in this investigation were clients depicting a reported fall. These patients with a fall record were mostly sixty five years and above in age. Apart from these highlighted inclusion criterion, the enrolled participants also depicted a Mini-Mental State Examination (MMSE) grade of more than twenty seven (Bedard 2003, pp. 45). Amongst the total number of the enrolled participants in the study, other features like the age, gender as well as psychiatric analysis were considered. Other attributes shown incorporated co-morbid physical features and medications administered. The study involved the comparison of all the enrolled participants. This was done through the use of control groups. These groups were observed to comprise of previous as well as next admission. These were specifically concerning the elderly patients.
The study only utilized the integration of the specific elderly patients from a similar or one ward. The study also involved the computation of the anticholinergic burden range. The score is usually dependent on the exemplified and calculated anticholinergic effect (Blow & Sajatovic 2007, pp. 79). Basically, this is always done with regard to a particular or every psychotropic compound that is received or consumed by a particular or specific subject. Like other several studies, this investigation depicted critical insights and lessons on the effects of these anticholinergic drugs and their effects. It is notable that amongst all the enrolled partakers, the anticholinergic burden range became eminent. Generally, this was discovered to be positively related to the higher instances of the falls within the elderly patients.
The Types of Anticholinergic Effects
These effects may be categorized into two basic types. There are peripheral as well as the central effects. These include some of the effects notable within the elderly patients with relation to the cognition and/or fall (Mintzer & Burns A 2000, pp. 460). The clinicians must pay keen attention to the feasibility of the noted side effects. Ideally, this is in order to have the capacity to effectively manage or treat these categories of the elderly patients. The probable medical complications associated with these anticholinergic side effects remain largely appreciable. It is notable that within the susceptible patients, specifically in the elderly patients or those with other historical conditions such as asthma, the noted effects might really be debilitating. The peripheral effects remain more physical. This is relative to the central.
Therefore, it is notable that the peripheral effects remain simpler to diagnose. Some of the potential symptoms might embody indication such as the dry mouth as well as constipation in the elderly patients. Other important symptoms observable within the elderly patients may include the urinary retention problems, bowel obstruction as well as much dilated pupils. Instances of blurred vision, elevated rates of heart beat and minimized sweating also include some of the potential emancipations of the symptoms. These outlined conditions indicate the symptoms of peripheral effects observed amongst the elderly patients. It is imperative to indicate that most peripheral effects might not be so severe. However, due to many reasons emanating from their already comprosmised health status, these symptoms must wary the elderly patients (Rudd, Raehl, Bond, Abbruscato & Stenhouse 2005, pp. 1595). In addition to this, the physicians must also take a lot of care. This is because the side effects may lead to the development of an array of medical complexities amongst the affected elderly patients.
The notable health complexities may range from lesions within the gums as well as respiratory complications. In this context, the emergence of complications and challenges associated with the hypothermia as well as the instances of myocardial infarction may also be notable amongst the elderly population (BALES & RITCHIE 2004, pp. 84). The analysis of the various central effects of the anticholinergic drugs amongst the elderly patients is critical. Mutilation in cognitive roles and processes has been widely identified as a basic and central challenge pertinent to the notable abnormalities for most schizophrenia conditions. These have been largely noted within the elderly patients studied overtime. The prior existing or historical impairments may get potentially exacerbated through the existence of central side effects. These side effects are caused by the notable anticholinergic features of most of the antipsychotic agents. These central effects of the anticholinergic drugs are mostly cerebral in the elderly patients.
Notably, they include impaired concentration and confusion. They might also depict through the emancipation of several conditions including attention deficit, as well as many instances of memory impairment (Miller 2009, pp. 78). There are past investigations that have revealed considerably vital aspects of these effects. A particular investigation done among the elderly patients revealed that delirium may be largely linked to the instances of elevated serum anticholinergic action and processes within adults. The study enrolled participants with an age of seventy five years and above. These enrolled participants lacked an elevated premormid risk associated with the delirium. In this study, the definition of the concept of high premorbid risk was evident (Chatterjee, Mehta, Sherer & Aparasu 2010, pp. 990). Basically, this was defined to be a more than elevated reliance or dependence on all the processes and actions within the daily living. The other considerations included the obvious terminal illnesses. The life expectancy applied in this context was not more than six months. There were also instances of admission into an intensive care unit.
The data based on critical factors associated with the delirium condition was gathered amongst all the existing enrolled participants into the study. Some of the conditions or factors highlighted or considered included the age, residence as well as comorbidity. Other considerations included the functional status as well as the instances of medication applied (Schoenberg & Scott 2008, pp. 34). An analysis of other significant factors such as the counts for the white blood cell and the existence of notable infection were evident. Ideally, to comprehensively examine the case of anticholinergic central effects within the elderly, there were other several factors of consideration to be observed. Some of these included the elements such as the glucose and sodium levels. An examination of the blood urea as well as nitrogen or creatinine was also vital.
The application of drugs that are potentially viewed or taken to be probable iatrogenic agents for delirium was eminent. These included the medication like the anticholinergic, neuroleptics, together with the narcotics. The benzodiazepines also formed important components of the drug effect survey or analysis (Flacker, Cummings, & Mach et al 1998, pp. 37). The following or consecutive empirical processes had critical revelations on the action of delirium on the elderly patients. It is vital to indicate that this particular investigation or research never included any atypical antipsychotics. However, the observed elevated existence of the delirium factor within these enrolled elderly patients was important.
Analytically, it may be observed that this factor indicated that the clinicians must be sensitive. Particularly, this is to the probability of the central effects within the enrolled or any other elderly patient that are prescribed the notable atypical antipsychotics (Stahl 2000, pp. 54). The indicated process of distinction may be potentially difficult to achieve within the normal therapeutic processes. The basic implications from such studies and reviews remain largely eminent. Generally, the clinicians must comprehensively take an initiative to interview the elderly patients. This is, particularly, applicable to those who are suspected to be languishing from the noted central side effect. Apart from this important clinical observation, it is also vital for these clinicians as well as other potential health care givers to play considerable and immediate attention to the responses of the elderly patients under these medications and processes.
Roots of the Anticholinergic Side Effects in the Elderly Patients
These impacts emanate from various factors and medications. There have been extensive research and investigations on the potential causes of these effects amongst the elderly patients. These investigations have depicted the instances of medications and types of drugs that play a significant role on these processes. The anticholinergic effects may emanate from the action or processes involving a wide plethora of mediations. There are indications that certain over-the-counter medications also play significant or potential roles in the development of these notable effects amongst the elderly (Carnahan, Lund, Perry, Culp & Pollock 2002, pp. 16). Basically, a majority of the anticholinergic medicines prescribed to help in the therapy and management of the EPS amongst the elderly patients suffering from schizophrenia are largely indicted to be the potential culprits for the development of the anticholinergic effects.
There is also a critical observation that the antipsychotics also have the potential to cause diverse instances of the anticholinergic. From these indications, it may be noted that various factors together with diverse drugs play an important role in the development or emancipation of the notable side effects of the anticholinergic drugs among the elderly patients. There is an important observation that any atypical antipsychotics is likely to vary in its anticholinergic strength (ALLEN 2007, pp. 9). This observation or process might potentially lead to the indication or development of an elevated higher capacity or competency for the development of the notable side effects. This occurs relative to the conditions notable within other potential drugs or medications. Most investigators have noted that the anticholinergic weight created by drugs such as clozapine as well as the risperidone have varying or diverse cognitive effects amongst the elderly patient s or groups of clients. These observations were noted after undertaking a series of cohort empirical studies on this topic.
Clozapine is regarded as a potential anticholinergic agent. On the other hand, it is imperative to note that risperidone is highly regarded to possess or depict reduced or minimized anticholinergic effects (Anderson, Lang & Weiner 2005, pp. 60). In conducting the investigations to note or discover these anticholinergic effects, there are remarkable considerations that require critical observations. For instance, the involvement of participants must adequately be regulated. In this sense, all the enrolled or intended participants for the study must be free from the notable neurologic as well as substance consumption complications. These might also include other notable complexities associated with the human central nervous system. An appropriate dose recommended for therapy must be properly monitored and controlled.
The elderly patients enrolled within such studies must not have any potentially anticholinergic propagators as well as medications that are most likely to have potential effects on the patients level of cognition. The overall cognitive capacity and operation may be monitored and recorded by the MMSE. According to most empirical investigations, both the clozapine as well as the risperidone have sustained statistically matching anticholinergic levels (LE 2001, pp. 11). However, most studies have failed to determine the correlation that may exist between the levels of the anticholinergic as well as the potential central side effects . These have also been observed for the case of the peripheral side effects. Principally, studies have endeavored to provide the evidence of diverse anticholinergic levels. This is normally observed between the atypical antipsychotics. The disparities between the antipsychotics olanzapine as well as the clozapine have been noted by most investigators (Pies & Rogers 2005. pp. 21). In these investigations, an analysis of the blood samples has indicated the olanzapine patients or partiticipants to have very low levels of the anticholinergic serum. This is unlike the observations of the clozapine group that depict a considerably high level of the serum.
Olanzapine-treated patients have also depicted reduced or minimized scores for the anticholinergic items (Cassel 2003, pp. 90). These may include constipation as well as the potential micturition disturbances. Apart from these, there might be development of other potential indications such as the increased rates of the elderly patient palpitations, together with tachycardia. On the other hand, few lozapine-treated clients scored within the notably impaired range. This observation was based on the items relating to the instances of occurrences such as constipation, palpitations together with excessive salivation. These provide very crucial insights into the likely effects of some of the anticholinergic drugs on the elderly patients. Basically, most investigations have indicated that atypical antipsychotics usually vary within their observable and potential levels of the anticholinergic. Although the effects attributed to these different levels have never been comprehensively noted, clinicians have to be aware of the feasibility of these dangerous side effects, particularly, this is with the utilization of the antipsychotics. Ideally, this is because these antipsychotics possess a very high anticholinergic level.
Some investigators have also reported the danger of administering or taking certain drugs in combination and their likelihood to cause potential health complications. For instance, medicines that are rarely imagined to be anticholinergic have this effect. The examples of such drugs include the furosemide or otherwise termed ad Lasix. This notable category might also embody other important examples such as the diltiazem or Cardizem (McEvoy 1983, pp. 300). Notably, these drugs are observed to have the potential of causing an eminent functional impairment. This situation might be, particularly, noted when these drugs are consumed in combination. All of these drugs posses the anticholinergic properties. Therefore, when administered or upon taking these drugs together, they develop and depict a potential additive or synergy effect of action. Observably, this trend remains very dangerous to the general health of all the elderly persons. This is because they significantly retard the operation and function capacities for these elderly persons or patients.
It is notable that moat studies have related these negative implications of the drugs acting in synergy to the projected extent of malfunction and other effects on the elderly patients. In this context, a four year disparity is indicated to exist. This transpires in a manner such that a particular seventy year old person would operate to the speed and general capacities of a seventy four year old (Tracy, Monaco & Abraham et al 1998, pp. 185). These disparities indicate the functional variances that may be developed due to the synergy effects of these drugs. Basically, it is vital to note the eminent effects of such other drugs on the health and performance of the elderly patient. Consequently, clinicians must take note to prevent the occurrence of such incidents amongst their patients. Therefore, the process of patient protection remains critical and applicable during such therapeutic interventions as well as procedures.
The elderly patients consuming a particular considerably anticholinergic medicine, like the cimetidine or the double mildly anticholinergic drugs like the furosemide or diltiazem depict peculiar tendencies (Blow & Sajatovic 2007, pp. 56). Basically, they have an elevated likelihood to have challenges with the very many daily life processes and operation. Some of the activities that these groups of people might have challenges in include dressing and bathing. Other notable tasks that these categories of elderly patients might face are also notable. These may include chores involving meal preparation. Apart from these observations on potential difficulties, such elderly patients might also have significant challenges in accomplishing routine tasks. For instance, the management of medication might be very difficult for this category of elderly patients. Therefore, in regard to these potential challenges, the physicians must take in considerable measures to assist these patients. An example of a proper initiative would be to indulge the services of a qualified and dedicated care giver or care provider. This would potentially assist in looking after the elderly patient in context.
There are several negative health conditions that have been associated with the anticholinergic effects amongst the elderly people (KATLIC 2011, pp. 43). These have been indicated by studies conducted within different global destinations and nations. The United States include some of the countries in which studies related to anticholinergic effects have been expansively done. These drugs have been linked to the poorer cognition as well as reduced strength and power observable within many adults. It is critical to observe that not much care has been provided to ensure that these dangerous drugs do not completely harm the elderly people. There are also no specific medical procedures meant for dealing with these complications. The lack of policy initiatives to help in the addressing of this problem or challenge is eminent within several nations (Chengappa, Pollock & Parepall et al 2000, pp. 315). The effect of these drugs on the function levels of the elderly patients has been a particular area of great interest for most potential researchers.
To assess the basic functional level, most enrolled participants in different studies or investigations have been requested to answer several questions. These questions asked have always bordered issues relating to the general life processes and activities. They have been asked questions concerning the functions relevant to the daily living. In attaining the intended fundamental goals, these studies have always engaged the application of a chain of observational recordings (KATLIC 2011, pp. 67). These have, particularly, included the monitoring of the gait speed. Investigations indicate that a considerable number of enrolled elderly patients or participants involved in the consumption of a single or several medicines. These medications were noted to posses the anticholinergic burden. However, a considerable observed small number of these enrolled elderly patients engaged in the consumption of medications that contained certain properties of anticholinergic.
The lack of comprehensive coverage and address of the challenges or complications emerging from the consumption of these drugs by the elderly patients emanate from different quarters (Mintzer & Burns 2000, pp. 461). For instance, most approaches or study methodologies might not include specific vital aspects within the general population under study or investigation. It is obvious that most cross-sectional designs might remarkably limit these studies. It is also very expensive and time consuming to launch a specifically successful and comprehensive investigation processes within the medical field. The human confounding factors also include other notable elements that have the potential to significantly limit study capacities and achievements. The notable effects of the anticholinergic drugs have also been attributed to several other factors by most investigations. For instance, lack of proper drug and therapy compliance by many elderly persons has been noted as major contributors of these observed effects.
The basic implication here is that most elderly persons have diminished capacities to comply with the dose arrangements (Lieberman 2004, pp. 22). Apart from this, they might be not aware of the negative effects and consequences of non-compliance or lack of observance of the critical medication processes. In turn, this may potentially lead to the emergence of the observed negative implications. Most investigations have been unable to clarify or distinguish the difference between the effects of drug non compliance and the effects of the anticholinergic drugs. These notable disparities might be associated with several factors including lack of awareness as well as the deficiency in the institution of proper monitoring and evaluation systems (Lauriello & Pallanti 2012, pp. 143). An examination of the existing literature heavily supports the high risk of the acute cognitive disruption. The available literature or information also supports the presence of chronic or long term impairment within the elderly persons.
The basic distinctive feature or characteristics of the identified population of the elderly group is notable. Actually, the distinguishing factor that enhances their uniqueness is that they are consumers of the anticholinergic medications. Most clinicians are very much aware of the potential side effects likely to emerge from the use or application of the anticholinergic drug category during the treatment of the elderly people (Karasek 2006, pp. 112). However, it is also recognized that most of these clinicians may lack the capacity to identify the various unique or distinctive anticholinergic properties notable within the new medications found in the larger market. This is, particularly, while considering those that depict very indirect anticholinergic features. There are indications that the drug therapies that contain the anticholinergic features are distinct. This might be due to very many factors (AYD 2000, pp. 11).
Ideally, anticholinergic burden may be defined as the noted cumulative effect derived upon the application or use of several medications that have the qualities of anticholinergic features concomitantly. There are indications that these types of medications have frequently been applied or used in the elder populations globally. Some of these medications are widely applicable and notable. These include the atropine, benztropine, as well the oxybutynin (TOLLISON, SATTERTHWAITE & TOLLISON 2001, pp. 101). These are applied particularly due to their inherent anticholinergic features among the elderly populations or patients. It is also vital to note that there are special categories of these medications. These include the examples like diphenhydramine, cyclobenzaprine, as well as the olanzapine (PAGOTO 2011, pp. 77). These categories of medications are very unique from the others. This is because they possess the anticholinergic features that are largely not associated or linked to their observ
Do you need this or any other assignment done for you from scratch?
We assure you a quality paper that is 100% free from plagiarism and AI.
You can choose either format of your choice ( Apa, Mla, Havard, Chicago, or any other)
NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.
NB: All your data is kept safe from the public.