Identification of medications that cause cognitive impairment in older people: the case of oxybutynin chloride.

摘要: OBJECTIVES: To evaluate the cognitive effects of acute challenges with antispasmodic agent oxybutynin hydrochloride in normal older volunteers and to compare these those attributable diphenhydramine, another commonly used medication anticholinergic (muscarinicblocking) activity. DESIGN: A double-blind, placebo-controlled cross-over study. SETTING: Laboratory evaluations community subjects. PARTICIPANTS: convenience sample 12 volunteers, average age 69.17 years. INTERVENTION: Baseline assessment was followed by randomized administration a placebo, (5 10 mg), diphenhydramine (50 mg) test sessions separated 1 week. MEASUREMENTS: Evaluation performance 1-hour battery pencil paper, interviewer-administered, computer-administered tests beginning 90 minutes after drug (or placebo) administration. RESULTS: Random regression analyses demonstrated that caused significant decrements on seven 15 measures, five measures. The most sensitive measures for detecting were Buschke Selective Reminding Test Reaction Time. CONCLUSIONS: These findings demonstrate can cause impairment suggest physicians prescribing it should monitor their patients facilitate early recognition who experience drug-related deficits. More generally, systematic research identify toxicity not recognized during process development or postmarketing surveillance.