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Antimuscarinic burden in COPD — GPhC CRA MCQ

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HardRespiratory TherapeuticsAntimuscarinic burden in COPDGPhC CRA

A 67-year-old man prescribed tiotropium Respimat reports dry mouth and difficulty passing urine. He has benign prostatic enlargement and recently started amitriptyline for neuropathic pain. What is the most appropriate action?

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Correct answer: D — Refer to the prescriber because antimuscarinic burden may be worsening urinary retention

Tiotropium and amitriptyline both contribute to antimuscarinic effects, and urinary difficulty in a man with prostatic enlargement may indicate retention risk. The prescriber should review the medicines and symptoms. Adding sedating antihistamines or oxybutynin would increase antimuscarinic burden. Increasing tiotropium would not address the adverse effect concern.

Reference: BNF