Among the following conditions, which would be a contraindication to prescribing an antimuscarinic medication?

Among the following conditions, which would be a contraindication to prescribing an antimuscarinic medication?

• A. Common cold
• B. GERD
• C. Toxic megacolon
• D. Hypertension

Answer: (C)

Antimuscarinics block parasympathetic activity, reducing smooth muscle tone and motility in the gut. This makes them risky in conditions where the bowel is already distended or at risk of paralysis, because further slowing of movement can worsen distention or lead to perforation. Toxic megacolon is a severe, dilated colon complication where further inhibition of colonic motility could be dangerous, potentially precipitating perforation or worsening the clinical course. That’s why this condition is a contraindication to prescribing an antimuscarinic. The other options don’t pose an absolute contraindication. A common cold is not a contraindication, though antimuscarinics can dry secretions and may have modest effects on symptoms. GERD can be exacerbated by some antimuscarinics due to reduced lower esophageal sphincter tone, so caution is warranted but not an outright contraindication. Hypertension isn’t a contraindication either, though these drugs can cause tachycardia in some individuals, it doesn’t by itself rule out use.

Antimuscarinics block parasympathetic activity, reducing smooth muscle tone and motility in the gut. This makes them risky in conditions where the bowel is already distended or at risk of paralysis, because further slowing of movement can worsen distention or lead to perforation.

Toxic megacolon is a severe, dilated colon complication where further inhibition of colonic motility could be dangerous, potentially precipitating perforation or worsening the clinical course. That’s why this condition is a contraindication to prescribing an antimuscarinic.

The other options don’t pose an absolute contraindication. A common cold is not a contraindication, though antimuscarinics can dry secretions and may have modest effects on symptoms. GERD can be exacerbated by some antimuscarinics due to reduced lower esophageal sphincter tone, so caution is warranted but not an outright contraindication. Hypertension isn’t a contraindication either, though these drugs can cause tachycardia in some individuals, it doesn’t by itself rule out use.