II. Definitions

  1. Cholinomimetic Alkaloids
    1. Plant extracts with similar activity as Choline esters (e.g. Acetylcholine), but not susceptible to Cholinesterases
    2. Other than Nicotine (which acts at Nicotinic Receptors), most are Muscarinic Agonists

III. Adverse Effects

IV. Mechanism: Images

V. Medications: Choline Derivatives

  1. Background
    1. Primarily Muscarinic ReceptorAgonists (M1, M2, M3), with weak nicotinic activity (see Cholinergic Activity)
  2. Carbachol (Isopto Carbachol)
    1. Use topically as an ophthalmic drop for Glaucoma
    2. Cholinesterase resistant, with a long Half-Life
  3. Methacholine (Provocholine)
    1. Used in the Inhalation Challenge Test in the evaluation of Suspected allergen or Exercise-Induced Asthma
    2. Administered during Pulmonary Function Test to trigger bronchoconstriction in susceptible patients
    3. Susceptible to Cholinesterase metabolism, with a short Half-Life
  4. Bethanechol (Urecholine)
    1. Used to stimulate gastrointestinal motility or increase Bladder emptying when not obstructed
    2. Cholinesterase resistant, with a long Half-Life

VI. Medications: Alkaloids

  1. Nicotinic Agonists
    1. Nicotine
  2. Muscarinic Agonists (M1, M2, M3)
    1. Cevimeline
      1. Used to treat Xerostomia in Sjogren Syndrome
    2. Pilocarpine (Isoptocarpine)
      1. Used as a Miotic agent in Glaucoma
      2. Used in Sweat Chloride test for Cystic Fibrosis evaluation
      3. Indicated in Xerostomia in Sjogren Syndrome

VII. References

  1. Olson (2020) Clinical Pharmacology, Medmaster, Treasure Island, Fl, p. 24

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Related Studies

Cost: Medications

bethanechol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
BETHANECHOL 10 MG TABLET Generic $0.20 each
BETHANECHOL 25 MG TABLET Generic $0.27 each
BETHANECHOL 5 MG TABLET Generic $0.22 each
BETHANECHOL 50 MG TABLET Generic $0.44 each