Details of the Drug

General Information of Drug (ID: DMUMQZ0)

Drug Name
Clidinium
Synonyms
clidinium; N-Methyl quinuclidinyl benzilate; 7020-55-5; 3-hydroxy-1-methylquinuclidinium benzilate ester; 3-{[hydroxy(diphenyl)acetyl]oxy}-1-methyl-1-azoniabicyclo[222]octane; Ro-23773; 3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-methyl-1-azonia-bicyclo[222]octane; 1-Azoniabicyclo(222)octane, 3-((hydroxydiphenylacetyl)oxy)-1-methyl-; [3H]clidinium; (-)MQNB; Clidinium bromid; (1-methyl-1-azoniabicyclo[222]octan-8-yl) 2-hydroxy-2,2-di(phenyl)acetate; 3-Hydroxy-1-methylquinuclidinium benzilate (ester); Quinuclidinium,; Librax (TN); Benzilic acid, ester with 3-hydroxy-1-methylquinuclidinium; Quinuclidinium, 3-hydroxy-1-methyl-, benzilate (ester); (1-methyl-1-azoniabicyclo[222]octan-3-yl) 2-hydroxy-2,2-diphenylacetate
Indication
Disease Entry ICD 11 Status REF
Abdominal stomach pain DD91.4 Approved [1], [2], [3]
Irritable bowel syndrome DD91.0 Approved [1], [2], [3]
Therapeutic Class
Analgesics
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 352.4
Topological Polar Surface Area (xlogp) 3.3
Rotatable Bond Count (rotbonds) 5
Hydrogen Bond Donor Count (hbonddonor) 1
Hydrogen Bond Acceptor Count (hbondacc) 3
Chemical Identifiers
Formula
C22H26NO3+
IUPAC Name
(1-methyl-1-azoniabicyclo[2.2.2]octan-3-yl) 2-hydroxy-2,2-diphenylacetate
Canonical SMILES
C[N+]12CCC(CC1)C(C2)OC(=O)C(C3=CC=CC=C3)(C4=CC=CC=C4)O
InChI
InChI=1S/C22H26NO3/c1-23-14-12-17(13-15-23)20(16-23)26-21(24)22(25,18-8-4-2-5-9-18)19-10-6-3-7-11-19/h2-11,17,20,25H,12-16H2,1H3/q+1
InChIKey
HOOSGZJRQIVJSZ-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
2784
ChEBI ID
CHEBI:3743
CAS Number
7020-55-5
DrugBank ID
DB00771
TTD ID
D0Q1BT
VARIDT ID
DR01421

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Muscarinic acetylcholine receptor (CHRM) TTOXS3C NOUNIPROTAC Antagonist [4]
Muscarinic acetylcholine receptor M1 (CHRM1) TTZ9SOR ACM1_HUMAN Antagonist [5]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Organic cation transporter 1 (SLC22A1) DTT79CX S22A1_HUMAN Substrate [6]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Abdominal stomach pain
ICD Disease Classification DD91.4
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
Muscarinic acetylcholine receptor M1 (CHRM1) DTT CHRM1 4.61E-07 -0.59 -0.73
Organic cation transporter 1 (SLC22A1) DTP SLC22A1 8.54E-01 1.24E-02 7.20E-02
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Clidinium
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
R0-93877 DMM4U9G Moderate Antagonize the effect of Clidinium when combined with R0-93877. Irritable bowel syndrome [DD91] [36]
Dicyclomine DMZSDGX Moderate Additive anticholinergic effects by the combination of Clidinium and Dicyclomine. Irritable bowel syndrome [DD91] [37]
Coadministration of a Drug Treating the Disease Different from Clidinium (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Bethanechol DMCLHO0 Moderate Antagonize the effect of Clidinium when combined with Bethanechol. Abnormal micturition [MF50] [38]
Oliceridine DM6MDCF Moderate Additive antimotility effects by the combination of Clidinium and Oliceridine. Acute pain [MG31] [39]
Mepyramine DMB4SFH Moderate Additive anticholinergic effects by the combination of Clidinium and Mepyramine. Allergic/hypersensitivity disorder [4A80-4A8Z] [40]
Phenyltoloxamine DMKAEQW Moderate Additive anticholinergic effects by the combination of Clidinium and Phenyltoloxamine. Allergic/hypersensitivity disorder [4A80-4A8Z] [40]
Tripelennamine DMZBU15 Moderate Additive anticholinergic effects by the combination of Clidinium and Tripelennamine. Allergic/hypersensitivity disorder [4A80-4A8Z] [37]
Memantine DMD9WSC Moderate Additive anticholinergic effects by the combination of Clidinium and Memantine. Alzheimer disease [8A20] [37]
Rivastigmine DMG629M Moderate Antagonize the effect of Clidinium when combined with Rivastigmine. Alzheimer disease [8A20] [41]
Donepezil DMIYG7Z Moderate Antagonize the effect of Clidinium when combined with Donepezil. Alzheimer disease [8A20] [41]
Desipramine DMT2FDC Moderate Additive anticholinergic effects by the combination of Clidinium and Desipramine. Attention deficit hyperactivity disorder [6A05] [37]
Cariprazine DMJYDVK Moderate Additive anticholinergic effects by the combination of Clidinium and Cariprazine. Bipolar disorder [6A60] [37]
Loperamide DMOJZQ9 Moderate Additive antimotility effects by the combination of Clidinium and Loperamide. Bowel habit change [ME05] [42]
Acetylcholine DMDF79Z Moderate Antagonize the effect of Clidinium when combined with Acetylcholine. Cataract [9B10] [43]
Umeclidinium DM4E8O9 Moderate Additive anticholinergic effects by the combination of Clidinium and Umeclidinium. Chronic obstructive pulmonary disease [CA22] [44]
Tiotropium DMFDC0Q Moderate Additive anticholinergic effects by the combination of Clidinium and Tiotropium. Chronic obstructive pulmonary disease [CA22] [44]
Revefenacin DMMP5SI Moderate Additive anticholinergic effects by the combination of Clidinium and Revefenacin. Chronic obstructive pulmonary disease [CA22] [44]
Dihydrocodeine DMB0FWL Moderate Additive CNS depression effects by the combination of Clidinium and Dihydrocodeine. Chronic pain [MG30] [45]
Alfentanil DMVO0UB Moderate Additive antimotility effects by the combination of Clidinium and Alfentanil. Corneal disease [9A76-9A78] [39]
Remifentanil DMZTXCH Moderate Additive antimotility effects by the combination of Clidinium and Remifentanil. Corneal disease [9A76-9A78] [39]
Arbutamine DMCY8AF Moderate Increased risk of rapid heart rate by the combination of Clidinium and Arbutamine. Coronary atherosclerosis [BA80] [46]
Ethanol DMDRQZU Moderate Additive CNS depression effects by the combination of Clidinium and Ethanol. Cystitis [GC00] [47]
Cyclobenzaprine DM1YBRM Moderate Additive anticholinergic effects by the combination of Clidinium and Cyclobenzaprine. Depression [6A70-6A7Z] [37]
OPC-34712 DMHG57U Moderate Additive anticholinergic effects by the combination of Clidinium and OPC-34712. Depression [6A70-6A7Z] [37]
Clomipramine DMINRKW Moderate Additive anticholinergic effects by the combination of Clidinium and Clomipramine. Depression [6A70-6A7Z] [37]
Doxepin DMPI98T Moderate Additive anticholinergic effects by the combination of Clidinium and Doxepin. Depression [6A70-6A7Z] [37]
Maprotiline DMPWB7T Moderate Additive anticholinergic effects by the combination of Clidinium and Maprotiline. Depression [6A70-6A7Z] [37]
Mepenzolate DM8YU2F Moderate Additive anticholinergic effects by the combination of Clidinium and Mepenzolate. Digestive system disease [DE2Z] [37]
Oxybutynine DMJPBAX Moderate Additive anticholinergic effects by the combination of Clidinium and Oxybutynine. Discovery agent [N.A.] [37]
Zonisamide DM0DTF7 Major Increased risk of hyperpyrexia by the combination of Clidinium and Zonisamide. Epilepsy/seizure [8A61-8A6Z] [48]
Diphenhydramine DMKQTBA Moderate Additive anticholinergic effects by the combination of Clidinium and Diphenhydramine. Episodic vestibular syndrome [AB31] [37]
Nadolol DMW6GVL Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Nadolol. Essential hypertension [BA00] [49]
Solifenacin DMG592Q Moderate Additive anticholinergic effects by the combination of Clidinium and Solifenacin. Functional bladder disorder [GC50] [37]
Tolterodine DMSHPW8 Moderate Additive anticholinergic effects by the combination of Clidinium and Tolterodine. Functional bladder disorder [GC50] [37]
Ketoconazole DMPZI3Q Moderate Decreased absorption of Clidinium due to altered gastric pH caused by Ketoconazole. Fungal infection [1F29-1F2F] [50]
Propantheline DM2EN6G Moderate Additive anticholinergic effects by the combination of Clidinium and Propantheline. Gastric ulcer [DA60] [37]
Pilocarpine DMV9ADG Moderate Antagonize the effect of Clidinium when combined with Pilocarpine. Glaucoma [9C61] [38]
Carvedilol DMHTEAO Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Carvedilol. Heart failure [BD10-BD1Z] [49]
Chlorothiazide DMLHESP Minor Altered absorption of Clidinium due to GI dynamics variation caused by Chlorothiazide. Heart failure [BD10-BD1Z] [51]
Hydroflumethiazide DMVPUQI Minor Altered absorption of Clidinium due to GI dynamics variation caused by Hydroflumethiazide. Heart failure [BD10-BD1Z] [51]
Acebutolol DM0TI4U Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Acebutolol. Hypertension [BA00-BA04] [49]
Penbutolol DM4ES8F Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Penbutolol. Hypertension [BA00-BA04] [49]
Nebivolol DM7F1PA Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Nebivolol. Hypertension [BA00-BA04] [49]
Pindolol DMD2NV7 Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Pindolol. Hypertension [BA00-BA04] [49]
Indapamide DMGN1PW Minor Altered absorption of Clidinium due to GI dynamics variation caused by Indapamide. Hypertension [BA00-BA04] [51]
Trichlormethiazide DMHAQCO Minor Altered absorption of Clidinium due to GI dynamics variation caused by Trichlormethiazide. Hypertension [BA00-BA04] [51]
Hydrochlorothiazide DMUSZHD Minor Altered absorption of Clidinium due to GI dynamics variation caused by Hydrochlorothiazide. Hypertension [BA00-BA04] [51]
Belladonna DM2RBWK Moderate Additive anticholinergic effects by the combination of Clidinium and Belladonna. Infectious gastroenteritis/colitis [1A40] [37]
Amantadine DMS3YE9 Moderate Additive anticholinergic effects by the combination of Clidinium and Amantadine. Influenza [1E30-1E32] [52]
Propiomazine DMKY8V1 Moderate Additive anticholinergic effects by the combination of Clidinium and Propiomazine. Insomnia [7A00-7A0Z] [37]
ITI-007 DMUQ1DO Moderate Additive anticholinergic effects by the combination of Clidinium and ITI-007. Insomnia [7A00-7A0Z] [37]
Physostigmine DM2N0TO Moderate Antagonize the effect of Clidinium when combined with Physostigmine. Lips/oral mucosa miscellaneous disorder [DA02] [41]
Neostigmine DM6T2J3 Moderate Antagonize the effect of Clidinium when combined with Neostigmine. Myasthenia gravis [8C6Y] [53]
Edrophonium DMCRQHB Moderate Antagonize the effect of Clidinium when combined with Edrophonium. Myasthenia gravis [8C6Y] [53]
Ambenonium DMOP0BL Moderate Antagonize the effect of Clidinium when combined with Ambenonium. Myasthenia gravis [8C6Y] [53]
Phenindamine DMDTC7R Moderate Additive anticholinergic effects by the combination of Clidinium and Phenindamine. Nasopharyngitis [CA00] [37]
Dimenhydrinate DM264B3 Moderate Additive anticholinergic effects by the combination of Clidinium and Dimenhydrinate. Nausea/vomiting [MD90] [37]
Promethazine DM6I5GR Moderate Additive anticholinergic effects by the combination of Clidinium and Promethazine. Nausea/vomiting [MD90] [37]
Cyclizine DM9G7BS Moderate Additive anticholinergic effects by the combination of Clidinium and Cyclizine. Nausea/vomiting [MD90] [37]
Metoclopramide DMFA5MY Moderate Antagonize the effect of Clidinium when combined with Metoclopramide. Nausea/vomiting [MD90] [54]
Polythiazide DMCH80F Minor Altered absorption of Clidinium due to GI dynamics variation caused by Polythiazide. Oedema [MG29] [51]
Levomethadyl Acetate DM06HG5 Moderate Additive CNS depression effects by the combination of Clidinium and Levomethadyl Acetate. Opioid use disorder [6C43] [45]
Oxymorphone DM65AGJ Moderate Additive antimotility effects by the combination of Clidinium and Oxymorphone. Pain [MG30-MG3Z] [39]
Levorphanol DMGS80V Moderate Additive antimotility effects by the combination of Clidinium and Levorphanol. Pain [MG30-MG3Z] [39]
Dezocine DMJDB0Y Moderate Additive antimotility effects by the combination of Clidinium and Dezocine. Pain [MG30-MG3Z] [39]
Flavoxate DMKV4NL Moderate Additive anticholinergic effects by the combination of Clidinium and Flavoxate. Pain [MG30-MG3Z] [37]
Nalbuphine DMOSQGU Moderate Additive antimotility effects by the combination of Clidinium and Nalbuphine. Pain [MG30-MG3Z] [39]
Buprenorphine DMPRI8G Moderate Additive antimotility effects by the combination of Clidinium and Buprenorphine. Pain [MG30-MG3Z] [39]
Hydrocodone DMQ2JO5 Moderate Additive antimotility effects by the combination of Clidinium and Hydrocodone. Pain [MG30-MG3Z] [39]
Biperiden DME78OA Moderate Additive anticholinergic effects by the combination of Clidinium and Biperiden. Parkinsonism [8A00] [37]
Levodopa DMN3E57 Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Levodopa. Parkinsonism [8A00] [55]
Orphenadrine DMW542E Moderate Additive anticholinergic effects by the combination of Clidinium and Orphenadrine. Parkinsonism [8A00] [37]
Methylscopolamine DM5VWOB Moderate Additive anticholinergic effects by the combination of Clidinium and Methylscopolamine. Peptic ulcer [DA61] [37]
Levomepromazine DMIKFEL Moderate Additive anticholinergic effects by the combination of Clidinium and Levomepromazine. Psychotic disorder [6A20-6A25] [37]
Quetiapine DM1N62C Moderate Additive anticholinergic effects by the combination of Clidinium and Quetiapine. Schizophrenia [6A20] [37]
Mesoridazine DM2ZGAN Moderate Additive anticholinergic effects by the combination of Clidinium and Mesoridazine. Schizophrenia [6A20] [37]
Aripiprazole DM3NUMH Moderate Additive anticholinergic effects by the combination of Clidinium and Aripiprazole. Schizophrenia [6A20] [37]
Iloperidone DM6AUFY Moderate Additive anticholinergic effects by the combination of Clidinium and Iloperidone. Schizophrenia [6A20] [37]
Paliperidone DM7NPJS Moderate Additive anticholinergic effects by the combination of Clidinium and Paliperidone. Schizophrenia [6A20] [37]
Perphenazine DMA4MRX Moderate Additive anticholinergic effects by the combination of Clidinium and Perphenazine. Schizophrenia [6A20] [37]
Molindone DMAH70G Moderate Additive anticholinergic effects by the combination of Clidinium and Molindone. Schizophrenia [6A20] [37]
Thiothixene DMDINC4 Moderate Additive anticholinergic effects by the combination of Clidinium and Thiothixene. Schizophrenia [6A20] [37]
Trifluoperazine DMKBYWI Moderate Additive anticholinergic effects by the combination of Clidinium and Trifluoperazine. Schizophrenia [6A20] [37]
Asenapine DMSQZE2 Moderate Additive anticholinergic effects by the combination of Clidinium and Asenapine. Schizophrenia [6A20] [37]
Pimozide DMW83TP Moderate Additive anticholinergic effects by the combination of Clidinium and Pimozide. Schizophrenia [6A20] [37]
Fentanyl DM8WAHT Moderate Additive antimotility effects by the combination of Clidinium and Fentanyl. Sensation disturbance [MB40] [39]
Pramlintide DM0EZ9Q Moderate Altered absorption of Clidinium due to GI dynamics variation caused by Pramlintide. Type-1/2 diabete [5A10-5A11] [56]
Chlorpheniramine DM5URA2 Moderate Additive anticholinergic effects by the combination of Clidinium and Chlorpheniramine. Vasomotor/allergic rhinitis [CA08] [37]
Methdilazine DMAUHQX Moderate Additive anticholinergic effects by the combination of Clidinium and Methdilazine. Vasomotor/allergic rhinitis [CA08] [37]
Trimeprazine DMEMV9D Moderate Additive anticholinergic effects by the combination of Clidinium and Trimeprazine. Vasomotor/allergic rhinitis [CA08] [40]
Brompheniramine DMFOVSD Moderate Additive anticholinergic effects by the combination of Clidinium and Brompheniramine. Vasomotor/allergic rhinitis [CA08] [37]
Acrivastine DMTIGA0 Moderate Additive anticholinergic effects by the combination of Clidinium and Acrivastine. Vasomotor/allergic rhinitis [CA08] [37]
⏷ Show the Full List of 90 DDI Information of This Drug

References

1 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 366).
2 Drug information of Clidinium, 2008. eduDrugs.
3 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
4 Pharmacological comparison of the cloned human and rat M2 muscarinic receptor genes expressed in the murine fibroblast (B82) cell line. J Pharmacol Exp Ther. 1998 Feb;284(2):500-7.
5 Accidental acute clidinium toxicity. Emerg Med J. 2009 Jun;26(6):460.
6 Identification of novel substrates and structure-activity relationship of cellular uptake mediated by human organic cation transporters 1 and 2. J Med Chem. 2013 Sep 26;56(18):7232-42.
7 Are organic cation transporters capable of transporting prostaglandins? Naunyn Schmiedebergs Arch Pharmacol. 2005 Aug;372(2):125-30.
8 Cisplatin and oxaliplatin, but not carboplatin and nedaplatin, are substrates for human organic cation transporters (SLC22A1-3 and multidrug and toxin extrusion family). J Pharmacol Exp Ther. 2006 Nov;319(2):879-86.
9 Pharmacologic markers and predictors of responses to imatinib therapy in patients with chronic myeloid leukemia. Leuk Lymphoma. 2008 Apr;49(4):639-42.
10 Organic cation transporters are determinants of oxaliplatin cytotoxicity. Cancer Res. 2006 Sep 1;66(17):8847-57.
11 Human intestinal transporter database: QSAR modeling and virtual profiling of drug uptake, efflux and interactions. Pharm Res. 2013 Apr;30(4):996-1007.
12 Implications of genetic polymorphisms in drug transporters for pharmacotherapy. Cancer Lett. 2006 Mar 8;234(1):4-33.
13 Upregulation of histone acetylation reverses organic anion transporter 2 repression and enhances 5-fluorouracil sensitivity in hepatocellular carcinoma
14 Comparison of type I and type II organic cation transport by organic cation transporters and organic anion-transporting polypeptides. J Pharmacol Exp Ther. 2001 Jul;298(1):110-5.
15 Organic cation transporters and their pharmacokinetic and pharmacodynamic consequences. Drug Metab Pharmacokinet. 2008;23(4):243-53.
16 Influx Transport of Cationic Drug at the Blood-Retinal Barrier: Impact on the Retinal Delivery of Neuroprotectants. Biol Pharm Bull. 2017;40(8):1139-1145.
17 Thiochrome enhances acetylcholine affinity at muscarinic M4 receptors: receptor subtype selectivity via cooperativity rather than affinity. Mol Pharmacol. 2004 Jan;65(1):257-66.
18 Pharmacological characterization of GSK573719 (umeclidinium): a novel, long-acting, inhaled antagonist of the muscarinic cholinergic receptors for treatment of pulmonary diseases. J Pharmacol Exp Ther. 2013 May;345(2):260-70.
19 Characterisation of [3H]-darifenacin as a novel radioligand for the study of muscarinic M3 receptors. J Recept Signal Transduct Res. 1997 Jan-May;17(1-3):177-84.
20 Lithocholylcholine, a bile acid/acetylcholine hybrid, is a muscarinic receptor antagonist. J Pharmacol Exp Ther. 2002 Oct;303(1):29-35.
21 Effects of propiverine hydrochloride (propiverine) on the muscarinic receptor binding affinity in guinea pig tissues and on salivation in conscious dogs. Nihon Yakurigaku Zasshi. 1999 Mar;113(3):157-66.
22 Clinical pipeline report, company report or official report of GlaxoSmithKline.
23 2018 FDA drug approvals.Nat Rev Drug Discov. 2019 Feb;18(2):85-89.
24 The amygdala modulates morphine-induced state-dependent memory retrieval via muscarinic acetylcholine receptors. Neuroscience. 2009 May 5;160(2):255-63.
25 Competitive and non-competitive antagonism exhibited by 'selective' antagonists at atrial and ileal muscarinic receptor subtypes. Br J Pharmacol. 1987 Apr;90(4):701-7.
26 Long-acting bronchodilators in COPD: Where are we now and where are we going Breathe 06/2014; 10(2):110-120.
27 Design, synthesis, and neurochemical evaluation of 5-(3-alkyl-1,2,4- oxadiazol-5-yl)-1,4,5,6-tetrahydropyrimidines as M1 muscarinic receptor agonists. J Med Chem. 1993 Apr 2;36(7):842-7.
28 Demonstration of bladder selective muscarinic receptor binding by intravesical oxybutynin to treat overactive bladder. J Urol. 2004 Nov;172(5 Pt 1):2059-64.
29 The role of M1 muscarinic cholinergic receptors in the discriminative stimulus properties of N-desmethylclozapine and the atypical antipsychotic dr... Psychopharmacology (Berl). 2009 Apr;203(2):295-301.
30 Ultraviolet spectroscopic estimation of microenvironments and bitter tastes of oxyphenonium bromide in cyclodextrin solutions. J Pharm Sci. 1999 Aug;88(8):759-62.
31 Formulation and biopharmaceutical evaluation of transdermal patch containing benztropine. Int J Pharm. 2008 Jun 5;357(1-2):55-60.
32 Autonomic cardiovascular control during a novel pharmacologic alternative to ganglionic blockade. Clin Pharmacol Ther. 2008 May;83(5):692-701.
33 Negative crosstalk between M1 and M2 muscarinic autoreceptors involves endogenous adenosine activating A1 receptors at the rat motor endplate. Neurosci Lett. 2009 Aug 14;459(3):127-31.
34 Capillary gas chromatography of trihexyphenidyl, procyclidine and cycrimine in biological fluids. J Chromatogr. 1989 Sep 29;494:135-42.
35 [Characterization of muscarinic receptors in undifferentiated thyroid cells in Fisher rats]. Endocrinol Nutr. 2009 Mar;56(3):106-11.
36 EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
37 Cohen MA, Alfonso CA, Mosquera M. Development of urinary retention during treatment with clozapine and meclizine [published correction appears in Am J Psychiatry 1994 Jun;151(6):952]. Am J Psychiatry. 1994;151(4):619-620. [PMID: 8147469]
38 Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255. [PMID: 376469]
39 Product Information. Apadaz (acetaminophen-benzhydrocodone). KemPharm, Inc, Coralville, IA.
40 Kulik AV, Wilbur R "Delirium and stereotypy from anticholinergic antiparkinson drugs." Prog Neuropsychopharmacol Biol Psychiatry 6 (1982): 75-82. [PMID: 7202232]
41 Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC "Explicit criteria for determining inappropriate medication use in nursing home residents." Arch Intern Med 151 (1991): 1825-32. [PMID: 1888249]
42 Eronen M, Putkonen H, Hallikainen T, Vartiainen H "Lethal gastroenteritis associated with clozapine and loperamide." Am J Psychiatry 160 (2003): 2242-2243. [PMID: 14638602]
43 Multum Information Services, Inc. Expert Review Panel.
44 Cole JM, Sheehan AH, Jordan JK "Concomitant use of ipratropium and tiotropium in chronic obstructive plmonary disease." Ann Pharmacother 46 (2012): 1717-21. [PMID: 23170031]
45 Product Information. Exalgo (hydromorphone). Covidien, Mansfield, MA.
46 Product Information. GenESA (arbutamine). Gensia Inc, San Diego, CA.
47 Linnoila M "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol 6 (1973): 107-12. [PMID: 4588850]
48 Product Information. Zonegran (zonisamide) Elan Pharmaceuticals, S. San Francisco, CA.
49 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
50 Product Information. Nizoral (ketoconazole). Janssen Pharmaceutica, Titusville, NJ.
51 Beermann B, Groschinsky-Grind M "Enhancement of the gastrointestinal absorption of hydrochlorothiazide by propantheline." Eur J Clin Pharmacol 13 (1978): 385-7. [PMID: 668798]
52 Postma JU, van Tilburg W "Visual hallucinations and delirium during treatment with amantadine (Symmetrel)." J Am Geriatr Soc 23 (1975): 212-5. [PMID: 123540]
53 Product Information. Mestinon (pyridostigmine). ICN Pharmaceuticals Inc, Cost Mesa, CA.
54 Product Information. Motilium (domperidone). Janssen-Ortho Inc, Toronto, ON.
55 Algeri S, Cerletti C, Curcio M, et al. "Effect of anticholinergic drugs on gastro-intestinal absorption of L-dopa in rats and man." Eur J Pharmacol 35 (1976): 293-9. [PMID: 1248506]
56 Product Information. Symlin (pramlintide). Amphastar Pharmaceuticals Inc, South El Monte, CA.