Anticholinergic syndrome (mechanism of disease)

This is a flowchart on anticholinergic syndrome, covering the etiology, pathophysiology, manifestations, and management. ADDITIONAL TAGS: Tachycardia Risk factors / SDOH Cell / tissue damage Nervous system path Anticholinergic syndrome Medicine / drugs Infectious / microbial Biochem / organic chem Immunology / inflammation Signs / symptoms Tests / imaging / labs Environment / toxins Genetics / hereditary Flow physiology Pathophysiology Management Etiology Manifestations Systemic blockage of acetylcholine → ↓ parasympathetic nervous system ↓ involuntary smooth muscles movement in: Gastrointestinal tract Urinary tract Lungs Sweat glands Arteries Dry mouth Thirst Constipation ↓ bowel sounds Paralytic ileus Urinary retention Warm, dry skin Eye Flushing Midriasis Photophobia ↑ intraocular pressure Glaucoma Confusion Agitation Delirium Belladonna poisoning: toxic leaves and berries contain atropine and scopolamine Jimson weed / Angel's trumpet (Datura stramonium) poisoning: also contains atropine and scopolamine, causes "gardener's pupil" Drugs that are primarily anticholinergic agents Drugs with anticholinergic properties / side effects Atropine Benztropine Trihexyphenidyl Tricyclic antidepressants (predominantly doxepin, amitriptyline, imipramine, and trimipramine) First-generation antihistamines (e.g., promethazine, dimenhydrinate) Reversible acetyl- cholinesterase inhibitor Physostigmine Don’t use with TCA ingestion → asystole Hallucinations Antipsychotics (clozapine, quetiapine) Anticholinergic delirium