Which patient condition might specifically require caution when prescribing anticholinergics?

Closed-angle glaucoma is a condition that requires caution when prescribing anticholinergic agents due to their potential to increase intraocular pressure. Anticholinergics work by blocking the action of acetylcholine at muscarinic receptors, which can lead to pupil dilation and ciliary muscle paralysis. These effects can exacerbate the already compromised drainage of aqueous humor in patients with closed-angle glaucoma, potentially resulting in acute glaucoma attacks. Therefore, clinicians must be particularly careful when considering anticholinergic medications for patients diagnosed with this eye condition to avoid worsening their situation.

In contrast, while other conditions such as chronic obstructive pulmonary disease, a history of seizures, and diabetes mellitus may have considerations for anticholinergic use, they do not present the same level of immediate and acute risk associated with increased intraocular pressure as closed-angle glaucoma does.