Cholinergic Agonist


Cholinergic Agonist, Cholinergic Receptor Agonist, Cholinomimetic, Nicotinic Agonist, Methacholine, Provocholine, Bethanechol, Urecholine, Cholinergic Agent, Parasympathomimetic Agent

  • 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
  • Adverse Effects
  • Mechanism
  • Images
  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
  • 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
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster, Treasure Island, Fl, p. 24