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

Images: Related links to external sites (from Bing)

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

Ontology: Parasympathomimetic Agents (C0030512)

Definition (MSH) Drugs that mimic the effects of parasympathetic nervous system activity. Included here are drugs that directly stimulate muscarinic receptors and drugs that potentiate cholinergic activity, usually by slowing the breakdown of acetylcholine (CHOLINESTERASE INHIBITORS). Drugs that stimulate both sympathetic and parasympathetic postganglionic neurons (GANGLIONIC STIMULANTS) are not included here.
Concepts Pharmacologic Substance (T121)
MSH D010277
SnomedCT 19581007, 372668005
English Parasympathomimetics, Agents, Parasympathomimetic, Drugs, Parasympathomimetic, Parasympathomimetic Agents, Parasympathomimetic Drugs, parasympathomimetic agent, parasympathomimetics, parasympathomimetics (medication), parasympathomimetic drugs, parasympathomimetic drug, parasympathomimetic agents, parasympathomimetic, PARASYMPATHOMIMETICS, Parasympathomimetic agents, Parasympathomimetic, Parasympathomimetic agent (product), Parasympathomimetic agent (substance), Parasympathomimetic agent, Parasympathomimetic agent, NOS
Swedish Parasympatomimetika
Czech parasympatomimetika, cholinomimetika
Finnish Parasympatomimeetit
French Médicaments parasympathomimétiques, Agents parasympathomimétiques, Parasympathomimétiques
Russian PARASIMPATOMIMETIKI, ПАРАСИМПАТОМИМЕТИКИ
Croatian PARASIMPATOMIMETICI
Polish Leki parasympatykomimetyczne
Japanese 副交感神経興奮薬, 副交感神経作動剤, 副交感神経作動薬, 副交感神経様作動物質, 副交感神経様作動薬, 副交感神経様作用薬物
Spanish Efecto Parasimpaticomimético, agente parasimpaticomimético (producto), agente parasimpaticomimético (sustancia), agente parasimpaticomimético, Parasimpaticomiméticos
Portuguese Efeito Parassimpatomimético, Parassimpatomiméticos
German Parasympathikomimetika
Italian Parasimpatomimetici

Ontology: Urecholine (C0041946)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D001626
Portuguese Urecolina
Spanish Urecolina
German Urecholin
English urecholine, Urecholine

Ontology: Bethanechol (C0053526)

Definition (MSH) A slowly hydrolyzing muscarinic agonist with no nicotinic effects. Bethanechol is generally used to increase smooth muscle tone, as in the GI tract following abdominal surgery or in urinary retention in the absence of obstruction. It may cause hypotension, HEART RATE changes, and BRONCHIAL SPASM.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D018723
SnomedCT 31690003, 372698003
LNC LP18907-3, MTHU006820
English Bethanechol, Bethanecol, 1-Propanaminium, 2-((aminocarbonyl)oxy)-N,N,N-trimethyl-, Bethanechol [Chemical/Ingredient], bethanecol, BETHANECHOL, bethanechol, Bethanechol (product), Bethanechol (substance)
Swedish Betankol
Czech bethanechol
Finnish Betanekoli
Russian BETANEKHOL, БЕТАНЕХОЛ
Japanese ベサネコール, 塩化ベタネコール, ベタネコール
Polish Betanechol, Chlorek betanecholu
French 2-Carbamoyloxy-N,N,N-triméthyl-propanaminium, 2-Carbamoyloxy-N,N,N-triméthylpropanaminium, 2-Carbamoyloxypropyl-triméthylammonium, 2-Carbamoyloxypropyl-triméthyl-ammonium, Béthanéchol
Spanish betanecol (producto), betanecol (sustancia), betanecol, Betanecol
German Bethanechol
Italian Betanecolo
Portuguese Betanecol

Ontology: Cholinergic Agents (C0242893)

Definition (MSH) Any drug used for its actions on cholinergic systems. Included here are agonists and antagonists, drugs that affect the life cycle of ACETYLCHOLINE, and drugs that affect the survival of cholinergic neurons. The term cholinergic agents is sometimes still used in the narrower sense of MUSCARINIC AGONISTS, although most modern texts discourage that usage.
Definition (CSP) drug used for its actions in stimulating cholinergic systems.
Concepts Pharmacologic Substance (T121)
MSH D018678
SnomedCT 19581007
English Agents, Cholinergic, Cholinergic Agents, cholinergic agent, Acetylcholine Agents, Agents, Acetylcholine, Cholinergic Drugs, Drugs, Cholinergic, cholinergic agents, cholinergic drugs, cholinergics, cholinergic drug, Cholinergics, Cholinergic agent, Cholinergic agent, NOS
French Médicaments cholinergiques, Cholinergiques, Agents acétylcholinergiques, Agents cholinergiques
Swedish Kolinerga medel
Czech cholinergní látky
Finnish Kolinergiset lääkkeet
Italian Agenti dell'acetilcolina, Colinergici, Farmaci colinergici, Sostanze colinergiche
Russian KHOLINERGICHESKIE SREDSTVA, KHOLINOPOZITIVNYE SREDSTVA, ATSETILKHOLINOVYE SREDSTVA, KHOLINOMIMETICHESKIE SREDSTVA, MUSKARINOVYE SREDSTVA, KHOLINOMIMETIKI, NIKOTINOVYE SREDSTVA, АЦЕТИЛХОЛИНОВЫЕ СРЕДСТВА, МУСКАРИНОВЫЕ СРЕДСТВА, НИКОТИНОВЫЕ СРЕДСТВА, ХОЛИНЕРГИЧЕСКИЕ СРЕДСТВА, ХОЛИНОМИМЕТИКИ, ХОЛИНОМИМЕТИЧЕСКИЕ СРЕДСТВА, ХОЛИНОПОЗИТИВНЫЕ СРЕДСТВА
Croatian Not Translated[Cholinergic Agents]
Polish Czynniki cholinergiczne, Środki pobudzające układ przywspółczulny
Portuguese Colinérgicos, Acetilcolínicos, Agentes Colinérgicos, Agentes Muscarínicos, Agentes de Acetilcolina, Efeito Colinérgico, Agentes Nicotínicos
Spanish Colinérgicos, Acetilcolínicos, Agentes Nicotínicos, Efecto Colinérgico, Agentes de Acetilcolina, Agentes Muscarínicos, Agentes Colinérgicos, agente colinérgico, droga colinérgica
Norwegian Not Translated[Cholinergic Agents]
German Acetylcholin-Analoga, Cholinergika

Ontology: Cholinergic Agonists (C0242894)

Definition (NCI) Any agent that is capable of activating cholinergic receptors (nicotinic and muscarinic) or of enhancing or prolonging the actions of acetylcholine.
Definition (MSH) Drugs that bind to and activate cholinergic receptors.
Concepts Pharmacologic Substance (T121)
MSH D018679
English Acetylcholine Agonist, Acetylcholine Agonists, Agonist, Acetylcholine, Agonist, Cholinergic, Agonists, Acetylcholine, Agonists, Cholinergic, Cholinergic Agonist, CHOLINERGIC AGON, CHOLINERGIC AG, ACETYLCHOLINE AGON, ACETYLCHOLINE AG, Cholinergic Agonists, cholinergic agonist, cholinergic agonists
French Agonistes de l'acétylcholine, Agonistes acétylcholinergiques, Agoniste cholinergique, Agonistes cholinergiques
Swedish Kolinerga stimulerare
Czech cholinergní agonisté
Finnish Kolinergit
Italian Agonisti dell'acetilcolina, Agonista dell’acetilcolina, Agonista colinergico, Agonisti colinergici
Russian ATSETILKHOLINA AGONISTY, KHOLINERGICHESKIE AGONISTY, АЦЕТИЛХОЛИНА АГОНИСТЫ, ХОЛИНЕРГИЧЕСКИЕ АГОНИСТЫ
Croatian Not Translated[Cholinergic Agonists]
Polish Agoniści cholinergiczni, Agoniści acetylocholiny
Japanese アセチルコリン作用薬, コリン作動剤, コリンアゴニスト, コリン作用薬, コリン作動性薬剤, コリン作動薬
German Acetylcholinagonisten, Cholinerge Agonisten
Portuguese Agonistas Colinérgicos, Agonistas da Acetilcolina
Spanish Agonistas de la Acetilcolina, Agonistas Colinérgicos

Ontology: Nicotinic Agonists (C0242948)

Definition (NCI) Natural or synthetic compounds mimicking acetylcholine neurotransmitter action at nicotinic receptors, which are ionotropic receptors that form ligand-gated ion channels in plasma membranes.
Definition (MSH) Drugs that bind to and activate nicotinic cholinergic receptors (RECEPTORS, NICOTINIC). Nicotinic agonists act at postganglionic nicotinic receptors, at neuroeffector junctions in the peripheral nervous system, and at nicotinic receptors in the central nervous system. Agents that function as neuromuscular depolarizing blocking agents are included here because they activate nicotinic receptors, although they are used clinically to block nicotinic transmission.
Concepts Pharmacologic Substance (T121)
MSH D018722
English Agonist, Nicotinic, Agonist, Nicotinic Cholinergic, Agonists, Nicotinic, Agonists, Nicotinic Cholinergic, Cholinergic Agonist, Nicotinic, Cholinergic Agonists, Nicotinic, Nicotinic Agonist, Nicotinic Cholinergic Agonist, Nicotinic Cholinergic Agonists, NICOTINIC AG, NICOTINIC AGON, CHOLINERGIC AGON NICOTINIC, CHOLINERGIC AG NICOTINIC, Nicotinic Acetylcholine Receptor Agonist, Nicotinic Receptor Agonist, nAChR Agonist, nicotinic agonist, nicotinic agonists, Nicotinic Agonists
French Agoniste nicotinique, Agonistes cholinergiques nicotiniques, Agonistes nicotiniques
Swedish Nikotinstimulerare
Czech cholinergní agonisté nikotinoví, receptory nikotinové - agonisté
Finnish Nikotiiniagonistit
Italian Agonisti colinergici nicotinici, Agonista nicotinco, Agonista colinergico nicotinico, Agonisti nicotinici
Russian NIKOTINOVYE AGONISTY, KHOLINERGICHESKIE AGONISTY NIKOTINOVYE, НИКОТИНОВЫЕ АГОНИСТЫ, ХОЛИНЕРГИЧЕСКИЕ АГОНИСТЫ НИКОТИНОВЫЕ
Polish Agoniści nikotyny
Japanese ニコチン作動剤, ニコチンアゴニスト, ニコチンコリン作用薬
German Cholinerge Agonisten, nicotinartige, Nicotinagonisten
Portuguese Agonistas Colinérgicos Nicotínicos, Agonistas Nicotínicos
Spanish Agonistas Colinérgicos Nicotínicos, Agonistas Nicotínicos

Ontology: Methacholine (C0600370)

Definition (CSP) parasympathomimetic cholinergic agonist with predominantly muscarinic effects.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D016210
SnomedCT 372766003, 53584007
LNC LP93758-8, LP121381-0, MTHU039807
English methacholine, METHACHOLINE, Methacholine (product), Methacholine (substance), Methacholine
Portuguese Metacolina
Spanish Metacolina, metacolina (producto), metacolina (sustancia), metacolina
German Methacholin
French Méthacholine

Ontology: Provocholine (C0722884)

Concepts Pharmacologic Substance (T121) , Indicator, Reagent, or Diagnostic Aid (T130) , Organic Chemical (T109)
MSH D016210
English Provocholine, Methapharma Brand of Methacholine Chloride, Roche Brand of Methacholine Chloride

Ontology: Cholinomimetic Drugs (C0871682)

Concepts Pharmacologic Substance (T121)
English Cholinomimetic Drugs

Ontology: Cholinergic receptor stimulating agent (C1720711)

Concepts Pharmacologic Substance (T121)
SnomedCT 421148003
English Cholinergic receptor stimulating agent (substance), Cholinergic receptor stimulating agent
Spanish agente estimulante de los receptores colinérgicos (sustancia), agente estimulante de los receptores colinérgicos