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Anticholinergic burden — GPhC CRA MCQ

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HardCNS TherapeuticsAnticholinergic burdenGPhC CRA

A 75-year-old woman is prescribed oxybutynin 5mg three times daily for urge incontinence. She has dementia, glaucoma and recurrent constipation requiring laxatives. Her daughter reports worsening confusion since starting it. What is the most appropriate action?

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Correct answer: B — Refer to the prescriber to review anticholinergic burden and alternatives

Oxybutynin has antimuscarinic effects and can worsen confusion, constipation and glaucoma-related risks in susceptible older people. The prescriber should review whether the medicine remains appropriate and consider alternatives. Adding sedating anticholinergics would worsen the burden. Pharmacists should not stop dementia medicines on the label without prescriber input.

Reference: BNF; NICE CKS Urinary incontinence