Summary of actions of some Cholinergic Agonists

Bethanechol ...
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Summary of actions of some Cholinergic Agonists



Bethanechol 

• Used in treatment of urinary retention 

• Binds preferentially at muscarinic receptors 



Carbachol 

• Produces miosis during ocular surgery 

• Used topically to reduce intraocular pressure in open-angle or narrow-angle glaucoma, particularly in patients who have become tolerant to pllocarplne 



Pilocarpine 

• Reduces intraocular pressure in open-angle and narrow-angle glaucoma 

• Binds preferentially at muscarinic receptors Uncharged, tertiary amine that can penetrate the CNS 



Physostigmine 

• Increases intestinal and bladder motility 

• Reverses CNS and cardiac effects of tricyclic antidepressants 

• Reverses CNS effects of atropine 

• Uncharged, tertiary amine that can penetrate the CNS 



Neostigmine 

• Prevents postoperative abdominal distention and urinary retention 

• Used In treatment of myasthenia gravis 

• Used as an antidote for competitive neuromuscular blockers 

• Has intermediate duration of action (0.5 to 2 hrs) 



Edrophonium 

• Used for diagnosis of myasthenia gravis 

• Used as an antidote for competitive neuromuscular blockers 

• Has short duration of action (10 to 20 min) 



Rivastigmine, galantamine, donepezil 

• Used as first-line treatments for Alzheimer's disease, though confers modest benefit 

• Have not been shown to reduce healthcare costs or delay institutionalization 

• Can be used with memantine (N-methyl-D-aspartate antagonist) with moderate to severe disease 



Echothiophate 

• Used in treatment of open-angle glaucoma 

• Has long duration of action (100 hours) 



Acetylcholine 

• Used to produce miosis in ophthalmic surgery 



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