Pharmacology Summary of direct acting cholinergic drugs Dr.

Mohammad Dmmaj

Drug Mechanism of action Uses Side effects & Contraind.

1. Acetylcholine Direct Stimulation of Muscarinic + - Not used clinically 1. S: Salivation
(Drops, I.V ) Nicotinic receptors - May be Used topically to produce miosis in ophthalmic surgery 2. L: Lacrimation
3. U: Urination
4. D: Diarrhea
5. G: GI/GU cramps
6. E: Emesis/ Eye (Miosis)
2. Methacholine - Direct Stimulation of M ±N receptor 1. Treatment of atrial tachycardia - Same as acetylcholine
(Oral or S.C) - Selective on C.V.S 2. Diagnosis of pheochromocytoma & a bronchial asthma
3. Carbachol - Direct Stimulation of M& N receptor 1. Eye drops to treat glaucoma →miosis + intraocular pressure + - Same as acetylcholine
(Oral ,drop, S.C) - Selective on Eye, GIT. &urinary tract Twitches(NM)
2. Postoperative paralytic ileus and gastric distention
3. Postoperative urine retention
4. Bethanechol - Stimulate M only 1. Postoperative paralytic ileus and gastric distention - Same as acetylcholine
(Oral or S.C) - More Selective on GIT & urinary 2. Postoperative urine retention
tract
5. Pilocarpine - Direct Stimulation of M ±N receptor 1. As eye drops - Salivation, Sweating,
1) Treatment of glaucoma(Not DOC)
(Oral or drops) - Selective on Eye& Exocrine gland Bradycardia, Diarrhoea
2) Antagonize mydriatics after fundus examination
3) Alternatively with mydriatics to cut adhesions between And Bronchospasm
iris and lens
2. Sialagogue( secretagogue) → treat Xerostoma
3. Diaphoretic
6. Cevimeline - Synthetic M3-selective 1. Sjögren’s syndrome - Similar to Pilocarpine
- Selective on Exocrine gland 2. Dry mouth caused by radiation