Parasympathomimetic drug

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A parasympathomimetic drug is a drug or poison that acts by stimulating or mimicking the parasympathetic nervous system (PSNS). These chemicals are also called cholinergics because acetylcholine (ACh) is the neurotransmitter used by the PSNS. Chemicals in this family can act either directly by stimulating the nicotinic or muscarinic receptors, or indirectly by inhibiting cholinesterase, promoting acetylcholine release, or other mechanisms. ^[1]

Some chemical weapons such as sarin or VX, non-lethal riot control agents such as tear gas, and insecticides such as diazinon fall into this category.

Pharmaceuticals

Direct-acting

These act by stimulating the nicotinic or muscarinic receptors.

• Choline esters
  • Acetylcholine (all acetylcholine receptors)
  • Bethanechol (M3 receptors)
  • Carbachol (all muscarinic receptors and some nicotinic receptors)
  • Methacholine (all muscarinic receptors)
• Plant alkaloids
  • Nicotine
  • Muscarine
  • Pilocarpine (M3 receptors)

Indirect-acting

Indirect acting parasympathomimetic drugs may be either reversible cholinesterase inhibitors, irreversible cholinesterase inhibitors or drugs that promote ACh release or Anti-adrenergic. The latter inhibits the antagonistic system, the sympathetic nervous system.

• Reversible cholinesterase inhibitors
  • Donepezil
  • Edrophonium
  • Neostigmine
  • Physostigmine
  • Pyridostigmine
  • Rivastigmine
  • Tacrine
• Irreversible cholinesterase inhibitors
  • Echothiophate
  • Isoflurophate
  • Malathion
• ACh release promoters
  • Cisapride
  • Metoclopramide
• Anti-adrenergics
  • clonidine (α-receptor agonist, α₂ > α₁, giving negative feedback)
  • propranolol (β2 antagonist)
  • atenolol (β1 antagonist)
  • prazosin (α1 antagonist)
  • methyldopa (α₂ agonist giving negative feedback)

References

See also

• Sympathomimetic drug

External links

• MeSH Parasympathomimetics

v • d • e Parasympathomimetics (N07A)
Anticholinesterases	Stigmine (Neostigmine, Pyridostigmine, Distigmine) - Ambenonium
Choline esters	Carbachol - Bethanechol
Other parasympathomimetics	Pilocarpine - Choline alfoscerate

v • d • e Ophthalmologicals: antiglaucoma preparations and miotics (S01E)
Sympathomimetics	Apraclonidine • Brimonidine • Clonidine • Dipivefrine • Epinephrine
Parasympathomimetics	Aceclidine • Acetylcholine • Carbachol • Demecarium • Echothiophate • Stigmine (Fluostigmine, Neostigmine, Physostigmine) • Paraoxon • Pilocarpine
Carbonic anhydrase inhibitors	Acetazolamide • Brinzolamide • Diclofenamide • Dorzolamide • Methazolamide
Beta blocking agents	Befunolol • Betaxolol • Carteolol • Levobunolol • Metipranolol • Timolol
Prostaglandin analogues	Bimatoprost • Latanoprost • Travoprost • Unoprostone
Other agents	Dapiprazole • Guanethidine

de:Parasympathomimetikum

ja:コリン作動薬 nl:Parasympathicomimeticumsk:Parasympatomimetikum

Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .