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Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

b) Carbachol c) Bethanechol "Urecholine"

1. Resistant to hydrolysis. 1.  Nicotinic effect.
2. Has a long duration of action. 2. Resistant to enzymatic hydrolysis.

3. Has both muscarinic & nicotinic activity So, it is a long-acting muscarinic drug
4. Uses as well as side effects like effective orally & S.C
methacholine but much more prolonged Uses: In atrial tachycardia, urinary

and therefore, more dangerous because retention, paralytic ileus & abdominal
of its nicotinic action. distension.
Use➔ miotic in glaucoma.

➢ Natural cholinergic alkaloids

Muscarine (not used) & pilocarpine.

Pilocarpine:

1. Strong muscarinic action similar to Ach (direct action on muscarinic
receptors).
Action
2. Has slight nicotinic action (Ganglionic stimulation) ➔ explain the release
of catecholamine from adrenal medulla ➔ slight hypertension.
• Ophthalmology as miotic in case of simple glaucoma.

Uses • Stimulates flow of saliva in-patient who complains of dryness of mouth
with ganglion blocking agent.

S/E Like Ach, blocked by atropine.

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