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James L. Rudolph, MD, SM; Marci J. Salow, PharmD; Michael C. Angelini, MA, PharmD; Regina E. McGlinchey, PhD

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In reply

We thank Kwatra for his comments and appreciate the opportunity to respond. The ARS was developed as a tool to identify patients at risk for adverse effects and as an aid to educate clinicians about medications with anticholinergic effects.¹ In development, the ARS medications were selected and ranked using the following 3 criteria: (1) the pK_i for cholinergic receptors, (2) reports of anticholinergic adverse effects from clinical trials, and (3) relevant MEDLINE searches. There was subjectivity to the selection and ranking of medications on the ARS, and the pK_i was used to provide a degree of objectivity. We focused primarily, but not exclusively, on the pK_i of the human muscarinic-1 (M-1) receptor. Because the pK_i of the human M-1 receptor subtype is not available for all . . . [Full Text of this Article]

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The Anticholinergic Risk Scale and Anticholinergic Adverse Effects in Older Persons
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