You have been asked to consult in the treatment of an 80-year-old patient. An antimuscarinic drug is being considered. Atropine therapy in the elderly may be hazardous because:
The elderly have a much higher incidence of glaucoma than younger people (and may be unaware of the disease until late in its course). Antimuscarinic agents may increase intraocular pressure in individuals with glaucoma. Elderly men (not women) have a much higher probability of developing urinary retention because they have high incidence of prostatic hyperplasia. Cardiac and hypehermic reactions to atropine are not common in the elderly. Ref: Chong N. (2011). Chapter 23. Lasers in Ophthalmology. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.
Atropine can elevate intraocular pressure in patients with glaucoma
Atropine frequently causes ventricular tachycardia
Urinary retention may be precipitated by atropine in women
The elderly are paicularly prone to develop dangerous hypehermia when given Atropine