Cholinergic Medications

Article Details


Pakala RS, Brown KN, Preuss CV

Cholinergic Medications


PubMed ID
30844190 [ View in PubMed

Cholinergic medications are a category of pharmaceutical agents that act upon the neurotransmitter acetylcholine, the primary neurotransmitter within the parasympathetic nervous system (PNS). There are two broad categories of cholinergic drugs: direct-acting and indirect-acting. The direct-acting cholinergic agonists work by directly binding to and activating the muscarinic receptors. Examples of direct-acting cholinergic agents include choline esters (acetylcholine, methacholine, carbachol, bethanechol, tacrine) and alkaloids (muscarine, pilocarpine, cevimeline). Indirect-acting cholinergic agents increase the availability of acetylcholine at the cholinergic receptors.[1] These include reversible agents (physostigmine, neostigmine, pyridostigmine, edrophonium, rivastigmine, donepezil, galantamine) and irreversible agents (echothiophate, parathion, malathion, diazinon, tabun, sarin, soman, carbaryl, propoxur).[2] The use of cholinergic agonists has limitations because of their tendency to cause adverse effects in any organ under the control of the parasympathetic nervous system. Some indications for use are listed below:

DrugBank Data that Cites this Article