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        Misuse of anticholinergic medications: a systematic review.

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        biomedicines_10_00355.pdf (PDF, 958Kb)
        Author
        Chiappini, Stefania
        Mosca, Alessio
        Miuli, Andrea
        Semeraro, Francesco
        Mancusi, Gianluca
        Santovito, Maria Chiara
        Di Carlo, Francesco
        Pettorruso, Mauro
        Guirguis, Amira
        Corkery, John M.
        Martinotti, Giovanni
        Schifano, Fabrizio
        di Giannantonio, Massimo
        Attention
        2299/25347
        Abstract
        (1) Background: Over the last decade, misuse and diversion of medications has appeared to be increasingly concerning phenomena, including a range of different molecules. As current knowledge on the abuse of centrally acting anticholinergics is limited, the aim of the present study is to review the relevant published data, focusing on the following molecules: benztropine, biperiden, scopolamine, orphenadrine, and benzhexol/trihexyphenidyl (THP). (2) Methods: A systematic literature review was carried out using Pubmed, Scopus, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Research methods were registered on PROSPERO (CRD42021257293). (3) Results: A total of 48 articles, including case reports, surveys, and retrospective case series analyses, were included. Most articles focused on benzhexol/THP (n = 25), and benztropine (n = 4). The routes of administration were mostly oral, and macrodoses together concomitant illicit drugs, e.g., cocaine, have been recorded. Toxidromes included both physical (e.g., tachycardia, tachypnoea, dilatated pupils, dry skin, urinary retention, ataxia, etc.) and psychiatric symptoms (e.g., anxiety, agitation, delirium, etc.). Fatal outcomes were very rare but reported. (4) Conclusion: Results from the present study show that anticholinergic misusing issues are both widespread worldwide and popular. Considering the potential adverse effects associated, healthcare professionals should be vigilant and monitor eventual misusing issues.
        Publication date
        2022-02-01
        Published in
        Biomedicines
        Published version
        https://doi.org/10.3390/biomedicines10020355
        Other links
        http://hdl.handle.net/2299/25347
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