Who may be more susceptible to anticholinergic effects?

• A. Avoid use in the elderly
• B. The pregnancy population
• C. Breast feeding mothers
• D. Young adults

Answer: (A)

Aging brings heightened sensitivity to drugs with anticholinergic effects. In older adults, changes in the nervous system and organ function amplify how these drugs affect acetylcholine pathways. There’s often reduced cholinergic reserve, greater brain permeability to drugs, and slower hepatic and renal clearance, so the same dose can produce stronger and longer-lasting effects. This increases the risk of delirium, confusion, memory problems, dry mouth, constipation, urinary retention, and blurred vision. Plus, polypharmacy is common in the elderly, which adds up to a higher cumulative anticholinergic burden.

Because of this, the elderly are more susceptible to these adverse effects. Pregnancy, breastfeeding, and young adults don’t inherently carry the same level of increased risk from aging-related factors, though pregnancy and lactation require other considerations for drug safety.