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Antimuscarinic adverse effects — DGM MCQ

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HardContinenceAntimuscarinic adverse effectsDGM

An 86-year-old woman with dementia and constipation has increasing falls after starting treatment for urinary urgency. She now has dry mouth and blurred vision. Her medicines include oxybutynin, rivastigmine patch, macrogol, amlodipine and paracetamol. Which medication should be reviewed?

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Reveal the answer and explanation

Correct answer: A — Oxybutynin

Oxybutynin is anticholinergic and can worsen cognition, constipation, blurred vision and falls. Rivastigmine may cause gastrointestinal adverse effects, but it does not explain the anticholinergic pattern. Continence treatment should not worsen the geriatric syndromes it is meant to help.

Reference: NICE NG123; BNF Prescribing in elderly