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Anticholinergic burden — GPhC CRA MCQ

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ModerateAdverse Drug Reactions and Drug SafetyAnticholinergic burdenGPhC CRA

An 80-year-old woman taking amitriptyline, oxybutynin and chlorphenamine reports dry mouth, constipation and new confusion. Her daughter asks for another sedating antihistamine. What is the most appropriate action?

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Correct answer: E — Avoid adding further anticholinergic burden and refer for medication review

Amitriptyline, oxybutynin and chlorphenamine all have anticholinergic effects. Dry mouth, constipation and confusion suggest clinically significant anticholinergic burden. Adding another sedating antihistamine could worsen cognition and falls risk. A structured medication review is appropriate.

Reference: BNF; NICE CKS