Which of the following are not acetylcholinergic side effects of diphenhydramine?

A. Paradoxical excitation: This is a central nervous system effect rather than an anticholinergic effect. Some patients, especially children and older adults, may experience agitation, hyperactivity, or insomnia after taking diphenhydramine, which is unrelated to its anticholinergic properties. B. Dry mouth: Dry mouth is a classic anticholinergic side effect caused by diphenhydramine’s inhibition of muscarinic receptors, which reduces salivary secretion and leads to discomfort and difficulty swallowing. C. Blurry vision: Blurred vision occurs due to anticholinergic-induced relaxation of the ciliary muscles and pupillary dilation, which impairs near vision and accommodation. It is a direct consequence of diphenhydramine’s cholinergic blockade. D. All of these are acetylcholinergic side effects of diphenhydramine: This is incorrect because paradoxical excitation is not an anticholinergic effect but a CNS stimulant-like reaction. Dry mouth and blurry vision are true anticholinergic effects.