Directly Acting Cholinoreceptor agonists (parasympathomimetics) Methacholine chloride -active at all of the muscarinic receptors (non-selective), but

has little effect on nicotinic receptors -bronchoconstrictor agent for diagnostic purposes (i.e. asthma) -adverse cardiovascular effects: bradycardia and hypotension -charged quarternary amine, insoluble to lipid cell membranes -β-methyl group Carbachol chloride -stimulates both muscarinic and nicotinic -carbamate ester; choline carbamate + quarternary ammonium -generally administered as an ophthalmic solution (i.e. treating glaucoma, cataract surgery) -effects: miosis and aqueous humor outflow Bethanechol chloride - selectively stimulates muscarinic receptors without any effect on nicotinic receptors -given orally or subcutaneously to treat urinary retention due to general anesthetic, diabetic neuropathy, side effects of antidepressants, -to treat gastrointestinal atony (lack of muscular tone) -1) contraction of the bladder and expulsion of urine; 2) increase gastrointestinal motility -treat these disorders only after mechanical obstruction is ruled out as a possible cause -Atropine: preoperatively; Bethanechol: post-operatively Alkaloid Pilocarpine - treat glaucoma; treat xerostomia (dry mouth)

myasthenia gravis Neostigmine -myasthenia gravis Physostigmine -treat glaucoma. mainly at the neuromuscular junction .treat for myasthenia gravis Pyridostigmine .Indirectly Acting Cholinoreceptor agonists Edrophonium -reversible acetylcholinesterase inhibitor .prevents breakdown of the neurotransmitter acetylcholine and acts by competitively inhibiting the enzyme acetylcholinesterase. Alzheimer’s disease. delayed gastric emptying Isofluorophate & Echothiophate -irreversible acetylcholinesterase inhibitor -treatment of chronic glaucoma Insecticides -malathion (low toxicity) and parathion (highly toxic) .