An anticholinergic agent is a substance that blocks the action of the neurotransmitter acetylcholine at synapses in the central and peripheral nervous system.
Anticholinergics may negatively impact cognition and memory 1) 2). Newer agents (tolterodine, darifenacin) have less impact on memory. Trospium, a quaternary amine, crosses the blood-brain barrier less readily than other anticholinergics and may have a less negative impact 3).
Bladder contraction is produced by ACh-mediated stimulation of postganglionic parasympathetic muscarinic cholinergic receptors on bladder smooth muscle. Anticholinergics bind M2 and M3 choline receptors and prevent stimulation. This increases bladder capacity by 50 ml and decreases bladder storage pressures by 15 cm H20 4).