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Misuse of Anticholinergic Medications: A Systematic Review

Stefania Chiappini Orcid Logo, Alessio Mosca Orcid Logo, Andrea Miuli Orcid Logo, Francesco Maria Semeraro, Gianluca Mancusi, Maria Chiara Santovito, Francesco Di Carlo Orcid Logo, Mauro Pettorruso Orcid Logo, Amira Guirguis Orcid Logo, John Martin Corkery Orcid Logo, Giovanni Martinotti Orcid Logo, Fabrizio Schifano, Massimo Di Giannantonio

Biomedicines, Volume: 10, Issue: 2, Start page: 355

Swansea University Author: Amira Guirguis Orcid Logo

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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 r...

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Published in: Biomedicines
ISSN: 2227-9059
Published: UK MDPI AG 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa59266
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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. 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spelling 2022-02-01T16:32:28.3186696 v2 59266 2022-01-29 Misuse of Anticholinergic Medications: A Systematic Review b49270b9a0d580cf4f31f9a1b6c93f87 0000-0001-8255-0660 Amira Guirguis Amira Guirguis true false 2022-01-29 PHAR (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. Journal Article Biomedicines 10 2 355 MDPI AG UK 2227-9059 anticholinergic drugs; drug misuse; drug abuse; drug diversion 1 2 2022 2022-02-01 10.3390/biomedicines10020355 COLLEGE NANME Pharmacy COLLEGE CODE PHAR Swansea University 2022-02-01T16:32:28.3186696 2022-01-29T13:56:35.2259552 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Stefania Chiappini 0000-0002-6810-1540 1 Alessio Mosca 0000-0003-3832-1398 2 Andrea Miuli 0000-0003-2431-0460 3 Francesco Maria Semeraro 4 Gianluca Mancusi 5 Maria Chiara Santovito 6 Francesco Di Carlo 0000-0001-8058-3426 7 Mauro Pettorruso 0000-0002-4164-3040 8 Amira Guirguis 0000-0001-8255-0660 9 John Martin Corkery 0000-0002-3849-817x 10 Giovanni Martinotti 0000-0002-7292-2341 11 Fabrizio Schifano 12 Massimo Di Giannantonio 13 59266__22281__d2c648ec3be44e989c8ca37a0487c30d.pdf 59266.pdf 2022-02-01T16:29:48.7569201 Output 981695 application/pdf Version of Record true © 2022 by the authors.This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license true eng https://creativecommons.org/licenses/by/4.0/
title Misuse of Anticholinergic Medications: A Systematic Review
spellingShingle Misuse of Anticholinergic Medications: A Systematic Review
Amira Guirguis
title_short Misuse of Anticholinergic Medications: A Systematic Review
title_full Misuse of Anticholinergic Medications: A Systematic Review
title_fullStr Misuse of Anticholinergic Medications: A Systematic Review
title_full_unstemmed Misuse of Anticholinergic Medications: A Systematic Review
title_sort Misuse of Anticholinergic Medications: A Systematic Review
author_id_str_mv b49270b9a0d580cf4f31f9a1b6c93f87
author_id_fullname_str_mv b49270b9a0d580cf4f31f9a1b6c93f87_***_Amira Guirguis
author Amira Guirguis
author2 Stefania Chiappini
Alessio Mosca
Andrea Miuli
Francesco Maria Semeraro
Gianluca Mancusi
Maria Chiara Santovito
Francesco Di Carlo
Mauro Pettorruso
Amira Guirguis
John Martin Corkery
Giovanni Martinotti
Fabrizio Schifano
Massimo Di Giannantonio
format Journal article
container_title Biomedicines
container_volume 10
container_issue 2
container_start_page 355
publishDate 2022
institution Swansea University
issn 2227-9059
doi_str_mv 10.3390/biomedicines10020355
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description (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.
published_date 2022-02-01T04:16:26Z
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