Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.1.8 (cholinesterase)
 12,691 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Behavioural therapy and anticholinergics are the mainstays in the treatment of symptoms of overactive bladder in patients with idiopathic and neurogenic detrusor overactivity; they are the first-line treatment. Oxybutynin, propiverine, tolterodine and trospium chloride as well as the "newcomers" solifenacin and darifenacin are comparable in regards to their efficacy. However, based on different pharmacokinetics and pharmacodynamics with different resorption velocity, different metabolisation and different CNS penetration, the profile of adverse events is different, qualitatively and quantitatively. Substances that are resorbed slowly or available as slow-release formulations are tolerated better. Lipophilic anticholinergics which pass the blood-brain barrier may compromise cognitive functions, especially in geriatric patients, who are already on cholinesterase inhibitors due to memory disorders. The following article gives an overview of the anticholinergics currently prescribed in patients with symptoms of overactive bladder with special attention to the influence of pharmacokinetics/pharmacodynamics on the adverse events profile including possible CNS side effects.
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PMID:[Oral anticholinergics in overactive bladder]. 1679 27

Antimuscarinic drugs are used for the treatment of overactive bladder. One adverse effect associated with their use, however, is cognitive impairment arising from their anticholinergic action. Here, we examined the effects of antimuscarinic drugs on learning using a passive avoidance task in rats. Drugs were intravenously administered 10 min before an acquisition trial, followed 24 h later by measurement of latency time in the passive avoidance task in a retention trial. Oxybutynin (0.1-1 mg/kg i.v.), propiverine (1-10 mg/kg i.v.) and scopolamine (0.1-1 mg/kg i.v.) impaired learning at doses of 0.3 mg/kg i.v. or more, 10 mg/kg i.v., and 0.3 mg/kg i.v. or more, respectively. Tolterodine (0.1-1 mg/kg i.v.) tended to impair these functions at a dose of 1 mg/kg i.v. In contrast, darifenacin (0.1-1 mg/kg i.v.) and solifenacin (0.3-3 mg/kg i.v.) showed no impairment of these functions. We also examined the effects of antimuscarinic drugs on learning enhanced by the cholinesterase inhibitor donepezil at a dose of 0.1 mg/kg i.v. in scopolamine-treated rats. Oxybutynin (0.1-1 mg/kg i.v.) impaired these donepezil-enhanced functions, whereas solifenacin (0.3-3 mg/kg i.v.) produced no significant impairment. These results suggest that antimuscarinic drugs such as darifenacin, solifenacin and tolterodine may have less effect on cognitive function in the treatment of patients with overactive bladder.
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PMID:Effect of antimuscarinic drugs used for overactive bladder on learning in a rat passive avoidance response test. 1720 78