ANTICHOLINERGICS

BENZHEXOL

GENERIC NAME Benzhexol

BRAND NAME ARTANE

PHARMACOLOGY CLASS Anticholinergic

DOSE FORM USED Tablets 2mg, 5mg

MOA  reduction of salivation and gastric secretions; inhibition of

intestinal motility

INDICATIONS  Parkinson's disease

 Drug-induced extrapyramidal disorders (except tardive

dyskinesia)

PRECUATIONS  Breastfeeding

o Appears safe

SIDE EFFECTS  Confusion & agitation

 Fast or irregular heart beat

 Eye pain

 Hearing or seeing things that are actually not present

 Drowsiness

 Dizziness

USUAL DOSE/ DOSE RANGE Tabs 2mg – 5mg daily on 3 to 4 divided dose (0,12,24)

STORAGE

o Do not freeze

o Protect from sunlight

o Keep out of reach from children

o Oral solution

o 20-25ᵒᴄ

o Tablets

 20-25ᵒᴄ

INTERACTIONS Does not interact well with other drugs( specific anticholinergic
 agents : increased risk of adverse anticholinergic agents

How to take, when to take Orally, take 1-2 tabs on divided dose (0,12,24)

When to see the doctor Consult your doctor if likely changes or missed doses or even if
experience side effects or if you are taking other drugs beside
Benzhexol

Ancillary instruction Finish the course

Appropriate counseling o Taken orally 3 to 4 divided dose daily before or with meals
to avoid nausea

o Let your pharmacist or doctor know if you’re taking other

drugs before taking Benzhexol

o This drugs should be taken between intervals, if you are

taking this tablets by mistake quickly consult your doctor

o This medicine is not to be stop abruptly, keep taking you

medicine until the doctor tells you how to reduce the dose
slowly

o If you miss a dose of this medicines, take it as possible,

however if it is almost time for your next dose. I.e. skip the
missed dose and continue with the regular dosing
schedule.

o If happen to experience side effects while on treatment

quickly consult your doctor, pharmacist or nurse as soon
as possible

o Store in original package and avoid sunlight and moisture

also keep away from children sight as much a possible

CYCLOPENTOLATE

Generic Name Cyclopentolate

Brand Name Cyclogy or A-K Pentolate

Dosage Formed used in 0.5% Eye drops

SI EML

MOA Reversibly block acetylcholine receptors on iris sphincter and ciliary muscle.

Indications Mydriasis

Cycloplegia
 Precautions Significant head injury

Side Effects Intolerance to bright light

Blurred vision

Drowsiness

Dosage 1 drop repeated after 5 minutes if necessary

IMPORTANT POINTS IMPORTANT POINTS OF COUNSELLING

OF COUNSELLING

How to take? When to  1 drop repeated after 5 minutes when needed

take? (Drug
 Taken as an eye drop
administration)

Ancillary Instruction  When needed

Side Effects  Drowsiness (Rare)/(Do not operate machines or drive car

 Blurry vision

 Affected to bright light

Interaction  Do not take with other drugs if so wait after 2 hours

 Avoid dust particles

 Reduce alcohol intake

Consult Doctor/  Consult Doctor or pharmacist if experience severe blurry vision,

Pharmacist if; drowsiness.

 Tell doctor if you are on treatment on other medications

Check Patients  Any QUESTIONS?

understanding about
drug

Benztropine

GENERIC NAME Benztropine

BRAND NAME Cogentin

Dosage form Injection 2mg in 2ml

PHARMACOLOGY CLASS Anticholinergic

MODE OF ACTION  inhibition of intestinal motility

INDICATION  Parkinson's disease

  Drug-induced extrapyramidal disorders (except
tardive dyskinesia)

 Acute dystonic reaction

PRECAUTION GI obstruction or atony—contraindicated.

Urinary obstruction—contraindicated.

Myasthenia gravis—contraindicated.

Heart disease (including arrhythmias, coronary heart

disease, and heart failure)—may be exacerbated.

Prostatic hypertrophy—symptoms may worsen.

Inflammatory bowel disease—risk of paralytic ileus.

Gastro-esophageal reflux—may be aggravated

SIDE EFFECTS Constipation, blurred vision, urinary retention, confusion ,

increase body temperature

USUAL DOSE/ DOSE RANGE Parkinson's disease

Oral, 0.5–1 mg daily, increase gradually up to 6 mg daily.

Drug-induced extrapyramidal disorders

Adult, oral 1–4 mg once or twice daily.

Child >3 years, oral 20–50 micrograms/kg once or twice

daily; maximum 6 mg daily.

Acute dystonic reaction

Adult, IM/IV 1–2 mg, follow with oral treatment if

necessary.

Child >3 years, IM/IV 20 micrograms/kg (maximum 1 mg);

may repeat after 15 minutes

STORAGE Store at room temperature. Keep away from reach of

children

Drug administration

Side effects for counseling This medicine may cause drowsiness, dizziness or blurred
vision and may increase the effects of alcohol; if affected, do
not drive or operate machinery.

Ancillary instruction Complete course.

Interaction Antacids may prevent the full absorption of Benztropine.

When to see a doctor/ come back to Parkinson's disease: do not stop taking this medicine
the pharmacy suddenly unless your doctor tells you to.