امرأة عمرها ٨١ سنة عندها إلحاح في البول وتسرب قبل الوصول للحمام، وبدأ لها الطبيب أوكسيبوتينين قبل أسبوعين. ابنتها تقول إنها صارت مشوشة وناسية وجافة الفم ومصابة بإمساك. الحرارة طبيعية، والبول نظيف. ما التفسير الأرجح؟

An 81-year-old woman with urinary urgency and leakage started oxybutynin two weeks ago. Her daughter says she is now confused, forgetful, dry-mouthed and constipated. Temperature is normal and urine is clear. What is the most likely explanation?

1. A new urinary infection without any urinary signs
2. Dehydration from poor intake unrelated to the drug
3. Anticholinergic effects of oxybutynin in an older adult
4. A sudden progression of Alzheimer’s over two weeks

Answer: C) Anticholinergic effects of oxybutynin in an older adult. Oxybutynin is anticholinergic and can cause confusion, dry mouth, constipation and retention, especially in older adults. The provider should review and change the drug.