Which of the following is NOT among the Beers Criteria listed as having strong anticholinergic properties among first-generation antihistamines?

• A. Brompheniramine
• B. Diphenhydramine
• C. Cetirizine
• D. Promethazine

Answer: (C)

Beers Criteria flag medications with strong anticholinergic effects because they can worsen delirium, confusion, constipation, and urinary retention in older adults. Among antihistamines, the ones with notable anticholinergic activity are the first-generation agents like diphenhydramine, brompheniramine, and promethazine. Cetirizine, on the other hand, is a second-generation antihistamine with minimal anticholinergic activity, so it is not listed as having strong anticholinergic properties. That’s why cetirizine is the correct choice for “not among the Beers Criteria listed as having strong anticholinergic properties.”