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136 SECTION II Autonomic Drugs
PREP AR A TIONS Cahill K et al: Pharmacological interventions for smoking cessation: An overview
and network meta-analysis. Cochrane Database Syst Rev 2013;5:CD009329.
A V AIL ABLE Carrière I et al: Drugs with anticholinergic properties, cognitive decline, and
dementia in an elderly general population. Arch Intern Med 2009;169:1317.
GENERIC NAME AVAILABLE AS Casaburi R et al: Improvement in exercise tolerance with the combination of tiotropium
and pulmonary rehabilitation in patients with COPD. Chest 2005;127:809.
ANTIMUSCARINIC ANTICHOLINERGIC DRUGS * Chapple CR et al: A comparison of the efficacy and tolerability of solifenacin
Aclidinium Tudorza Pressair succinate and extended release tolterodine at treating overactive bladder
Atropine Generic syndrome: Results of the STAR trial. Eur Urol 2005;48:464.
Belladonna alkaloids, extract, Generic Cohen JS et al: Dual therapy strategies for COPD: The scientific rationale for
or tincture LAMA+LABA. Int J Chron Obstruct Pulmon Dis 2016;11:785.
Botulinum toxin A Botox Ehlert FJ, Pak KJ, Griffin MT: Muscarinic agonists and antagonists: Effects on
gastrointestinal function. In: Fryer AD et al (editors): Muscarinic Receptors.
Clidinium Generic, Quarzan, others Handb Exp Pharmacol 2012;208:343.
Cyclopentolate Generic, Cyclogyl, others Filson CP et al: The efficacy and safety of combined therapy with α-blockers and
Darifenacin Generic, Enablex anticholinergics for men with benign prostatic hyperplasia: A meta-analysis.
J Urol 2013;190:2013.
Dicyclomine Generic, Bentyl, others Fowler CJ, Griffiths D, de Groat WC: The neural control of micturition. Nat Rev
Fesoterodine Toviaz Neurosci 2008;9:453.
Flavoxate Generic, Urispas Kranke P et al: The efficacy and safety of transdermal scopolamine for the preven-
Glycopyrrolate Generic, Robinul (systemic) tion of postoperative nausea and vomiting: A quantitative systematic review.
Seebri Neohaler (oral inhalation) Anesth Analg 2002;95:133.
Homatropine Generic, Isopto Homatropine, others Kruse AC et al: Muscarinic acetylcholine receptors: Novel opportunities for drug
development. Nat Rev Drug Discov 2014;13:549.
l-Hyoscyamine Anaspaz, Cystospaz-M, Levsin, others Lawrence GW, Aoki KR, Dolly JO: Excitatory cholinergic and purinergic signal-
Ipratropium Generic, Atrovent ing in bladder are equally susceptible to botulinum neurotoxin A consistent
Mepenzolate Cantil with co-release of transmitters from efferent fibers. J Pharmacol Exp Ther
Methscopolamine Generic, Pamine 2010;334:1080.
Oxybutynin Generic, Ditropan, Gelnique, others Marquardt K: Mushrooms, amatoxin type. In: Olson K (editor): Poisoning & Drug
Overdose, 6th ed. New York: McGraw-Hill, 2012.
Propantheline Generic, Pro-Banthine, others Profita M et al: Smoke, choline acetyltransferase, muscarinic receptors, and fibro-
Scopolamine blast proliferation in chronic obstructive pulmonary disease. J Pharmacol
Oral Generic Exp Ther 2009;329:753.
Ophthalmic Isopto Hyoscine Rai BP et al: Anticholinergic drugs versus non-drug active therapies for non-
neurogenic overactive bladder syndrome in adults. Cochrane Database Syst
Transdermal Transderm Scop Rev 2012;12:CD003193.
Solifenacin Vesicare Tauterman CS et al: Molecular basis for the long duration of action and kinetic
Tiotropium Spiriva selectivity of tiotropium for the muscarinic M3 receptor. J Med Chem
Tolterodine Generic, Detrol 2013;56:8746.
Tropicamide Generic, Mydriacyl Ophthalmic, Thai DM et al: Crystal structures of the M1 and M4 muscarinic acetylcholine
receptors. Nature 2016;335:2016.
others Wallukat G, Schimke I: Agonistic autoantibodies directed against G-protein-
Trospium Generic, Sanctura coupled receptors and their relationship to cardiovascular diseases. Semin
Umeclidinium Incruse Ellipta Immunopathol 2014;36:351.
GANGLION BLOCKERS Young JM et al: Mecamylamine: New therapeutic uses and toxicity/risk profile.
Clin Ther 2001;23:532.
Mecamylamine Vecamyl Zhang L et al: A missense mutation in the CHRM2 gene is associated with familial
CHOLINESTERASE REGENERATOR dilated cardiomyopathy. Circ Res 2008;102:1426.
Pralidoxime Generic, Protopam
Treatment of Anticholinesterase Poisoning
* Antimuscarinic drugs used in parkinsonism are listed in Chapter 28.
Nachon F et al: Progress in the development of enzyme-based nerve agent bioscav-
engers. Chem Biol Interact 2013;206:536.
REFERENCES Thiermann H et al: Pharmacokinetics of obidoxime in patients poisoned with
Brodde OE et al: Presence, distribution and physiological function of adrenergic organophosphorus compounds. Toxicol Lett 2010;197:236.
and muscarinic receptor subtypes in the human heart. Basic Res Cardiol Weinbroum AA: Pathophysiological and clinical aspects of combat anticholinesterase
2001;96:528. poisoning. Br Med Bull 2005;72:119.
C ASE STUD Y ANSWER
JH’s symptoms are often displayed by patients following frequency can diminish with time after prostatectomy as
prostatectomy to relieve significant obstruction of bladder detrusor muscle instability subsides. JH can be helped by
outflow. Urge incontinence can occur in patients whose pros- daily administration of a single tablet of extended-release
tatic hypertrophy caused instability of the detrusor muscle. tolterodine (4 mg/d) or oxybutynin (5–10 mg/d). A transder-
JH should be advised that urinary incontinence and urinary mal patch containing oxybutynin (3.9 mg/d) is also available.