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Anticholinergic burden — DGM MCQ

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EasyPolypharmacyAnticholinergic burdenDGM

An 83-year-old woman has dry mouth, constipation and new confusion. She was recently treated for urinary urgency. Examination shows no focal neurology and urine culture is negative. Current medicines include oxybutynin, amlodipine, atorvastatin and macrogol. Which medication should be reviewed?

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Correct answer: C — Oxybutynin

Oxybutynin has anticholinergic effects that can cause constipation, dry mouth, urinary retention and delirium. Amlodipine and atorvastatin have different adverse-effect profiles, macrogol treats constipation, and paracetamol is not the likely cause. Anticholinergic burden is a key target in older-adult prescribing review.

Reference: STOPP/START criteria v3; NICE NG56; BNF