Editing AUA: Overactive Bladder (2019) (section)

===== Contraindications =====
#'''<span style="color:#ff0000">Narrow angle glaucoma</span>''' (unless approved by the treating ophthalmologist)
#'''<span style="color:#ff0000">Dementia</span>'''
#*Anti-cholinergics may be contraindicated entirely depending on the level of cognitive impairment.
#'''<span style="color:#ff0000">Impaired gastric emptying</span>'''
#*Prior to initiation of anti-cholinergics, a patient at risk for gastric emptying problems should receive clearance from a gastroenterologist
#'''<span style="color:#ff0000">Use of solid oral forms of potassium chloride</span>'''
#*Reduced gastric emptying potentially caused by the anti-cholinergics may increase the potassium absorption of these agents.
#*Anti-cholinergic therapy may be used with caution with alternative forms of potassium chloride.
#'''<span style="color:#ff0000">History of urinary retention</span>'''
##Prior to initiation of anti-cholinergics, a patient with history of urinary retention should receive clearance from a urologist.
##*A PVR may be useful in any patient suspected of a higher risk of urinary retention.
#'''<span style="color:#ff0000">Use caution in prescribing anti-cholinergics in patients who are already using''' '''other medications with anti-cholinergic properties.</span>'''
#* '''<span style="color:#ff0000">Medications with anti-cholinergic properties include (3)</span>'''
#*#'''<span style="color:#ff0000">Tricyclic antidepressants</span>'''
#*#'''<span style="color:#ff0000">Medications for Parkinsonism, other extra-pyramidal diseases and Alzheimer’s disease</span>''' (benzotropine, biperiden HCl, galantamine, rivastigmine and trihexyphenidyl HCl)
#*#'''<span style="color:#ff0000">Acetylcholinesterase inhibitors (donepezil)</span>'''
#*'''Certain anti-nausea medications and those with atropine-like properties may also potentiate adverse events.'''
#**Examples include trimethaphan, methscopolamine bromide and ipratropium
#'''<span style="color:#ff0000">Use caution in prescribing anti-cholinergics or β3-adrenoceptor agonists in the frail OAB patient.</span>'''
#* '''Frail patients are defined as patients with mobility deficits (i.e., require support to walk, have slow gait speed, have difficulty rising from sitting to standing without assistance), weight loss and weakness without medical cause and who may have cognitive deficits'''
#*'''OAB medication trials generally are not conducted in the frail elderly''', resulting in a lack of efficacy and AE data in this group. 
#**Additional AEs are reported in this group, including impaired thermoregulation with dangerous core temperature elevation.
#* Polypharmacy is common in frail community-dwelling patients, placing them at higher risk for AEs, including impaired cognition.