Which of the following is a skeletal muscle relaxant with strong anticholinergic properties?

• A. Cyclobenzaprine
• B. Tolterodine
• C. Oxybutynin
• D. Benztropine

Answer: (A)

Cyclobenzaprine is a skeletal muscle relaxant that also has strong anticholinergic effects, similar to certain older antidepressants, which increases the risk of confusion, dry mouth, constipation, urinary retention, and delirium in older adults. Because the Beers Criteria highlights high anticholinergic burden as a concern in elderly patients, cyclobenzaprine is flagged for use in this population. The other options are not skeletal muscle relaxants: tolterodine and oxybutynin are antimuscarinic drugs for overactive bladder, and benztropine is an anticholinergic used for Parkinsonism. Thus, cyclobenzaprine best fits the description of a skeletal muscle relaxant with strong anticholinergic properties.