59.下列何者因具有很強的anticholinergic effects，年長者..-阿摩線上測驗

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59.下列何者因具有很強的anticholinergic effects，年長者應避免使用？
(A)quinidine
(B)quinapril
(C)desmopressin
(D)dextromethorphan

專技 - 調劑學與臨床藥學- 110 年 - 110-2 專技高考_藥師（二）：調劑學與臨床藥學#99930

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Filgrastim zz 大二上 (2022/07/15)

Anticholinergic activity of medications Class Drugs Relative anticholinergic potency Antihistamines H₁ receptor antagonists, first-generation: brompheniramine, carbinoxamine, chlorpheniramine, clemastine, cyproheptadine, dimenhydrinate, diphenhydramine, doxepin, doxylamine, hydroxyzine, meclizine, triprolidine, others High H₁ receptor antagonists, second-generation: fexofenadine, cetirizine*, loratadine, desloratadine, levocetirizine, others Low Antiparkinson Benztropine, trihexyphenidyl High Amantadine, bromocriptine, entacapone Low Analgesic Opioids: codeine, hydrocodone, fentanyl...
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Anticholinergic activity of medications

Class	Drugs	Relative anticholinergic potency
Antihistamines	H₁ receptor antagonists, first-generation: brompheniramine, carbinoxamine, chlorpheniramine, clemastine, cyproheptadine, dimenhydrinate, diphenhydramine, doxepin, doxylamine, hydroxyzine, meclizine, triprolidine, others	High
Antihistamines	H₁ receptor antagonists, second-generation: fexofenadine, cetirizine*, loratadine, desloratadine, levocetirizine, others	Low
Antiparkinson	Benztropine, trihexyphenidyl	High
Antiparkinson	Amantadine, bromocriptine, entacapone	Low
Analgesic	Opioids: codeine, hydrocodone, fentanyl, meperidine, methadone, morphine, oxycodone, tramadol, others	Low
Antimuscarinic, overactive bladder	Darifenacin, fesoterodine, flavoxate, oxybutynin, solifenacin, tolterodine, trospium	High
Antimuscarinic, spasmolytic	Atropine, belladonna-containing medications, clidinium-chlordiazepoxide, dicyclomine, hyoscyamine, glycopyrrolate, homatropine, methscopolamine, propantheline, scopolamine (hyoscine)	High
Antimuscarinic, inhaled bronchodilator	Ipratropium, tiotropium	High (local effect)
Antimuscarinic, ophthalmic drops (mydriatic/cycloplegic)	Atropine, cyclopentolate, homatropine, scopolamine	High (local effect)
Cardiovascular	Disopyramide	Low
Gastrointestinal	Antiemetics (eg, hydroxyzine, meclizine, promethazine, scopolamine); also refer to first-generation antihistamines above	High
	Domperidone, loperamide, prochlorperazine	Low
	H₂ receptor antagonists (cimetidine, famotidine^¶)	Low
Muscle relaxant	Orphenadrine, tizanidine	High
Muscle relaxant	Cyclobenzaprine*, baclofen, methocarbamol	Low
Psychotropic	Antipsychotics, first-generation: chlorpromazine, fluphenazine, loxapine, methotrimeprazine (levomepromazine), thioridazine, trifluoperazine	High
	Antipsychotics, first-generation: haloperidol, perphenazine*, others	Low
	Antipsychotics, second-generation: clozapine	High
	Antipsychotics, second-generation: olanzapine, quetiapine, iloperidone, risperidone, others	Low
	Benzodiazepines: chlordiazepoxide, clonazepam, temazepam, triazolam	Low
	Selective serotonin reuptake inhibitor (SSRI) antidepressants: citalopram, fluoxetine, fluvoxamine, paroxetine*	Low
	Tricyclic antidepressants: amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, others	High
Other neurologic	Carbamazepine, lithium, nefazodone, oxcarbazepine, phenelzine, trazodone	Low

ref: UpToDate: Drug prescribing for older adults

檢舉

10F

少了汪汪的太平洋肩只好自己高三下 (2022/07/19)

補充
Dextromethorphan 是 codeine 的類似物，但無止痛效果及成癮作用，可直接作用於延髓咳嗽中樞，抑制咳嗽反射。

過量與中毒
症狀包括精神紊亂、嗜睡或暈眩、嚴重的噁心或嘔吐、不尋常的興奮或緊張、激動狀態。

因為像codeine 會被當成興奮劑使用

檢舉

11F

考運旺旺旺大一上 (2023/06/22)

dextromethorphan 引起 serotonin syndrome

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59.下列何者因具有很強的anticholinergic effects，年長者..-阿摩線上測驗

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