Cholinergic Drugs

Match the Drug to Its Effect

Bethanechol

Stimulates GI motility and bladder contraction; treats urinary retention and postoperative ileus

Pilocarpine

Causes miosis and increases aqueous humor outflow (glaucoma); increases salivation (xerostomia)

Carbachol

Causes miosis and decreases intraocular pressure (used topically for glaucoma)

Methacholine

Used in bronchial challenge testing; causes bronchoconstriction

Muscarine

Toxic mushroom compound; causes SLUDGE symptoms (salivation, lacrimation, urination, diarrhea, GI upset, emesis)

Edrophonium

Short-acting; used to diagnose myasthenia gravis

Neostigmine

Reverses non-depolarizing NMJ blockade; treats myasthenia gravis and urinary retention

Pyridostigmine

Long-acting; used for chronic management of myasthenia gravis

Physostigmine

Crosses BBB; used to treat anticholinergic toxicity (e.g., atropine overdose)

Rivastigmine / Donepezil

Increases ACh in the CNS; used for Alzheimer’s disease

Echothiophate

Irreversible AChE inhibitor used topically for glaucoma

Pralidoxime (2-PAM)

Regenerates AChE after organophosphate poisoning (before aging)

Atropine

Blocks muscarinic receptors; antidote for AChE inhibitor toxicity

Atropine

Causes mydriasis, cycloplegia, tachycardia, decreased secretions; used for bradycardia and AChE toxicity

Scopolamine

Causes CNS depression and sedation; used for motion sickness and postoperative nausea

Ipratropium (Atrovent)

Causes bronchodilation; short-acting for COPD/asthma

Tiotropium

Causes bronchodilation; long-acting (24 hr) inhaler for COPD/asthma

Glycopyrrolate (Robinul)

Reduces salivation and respiratory secretions; pre-op use

Tropicamide / Cyclopentolate

Causes mydriasis and cycloplegia; used for eye exams

Oxybutynin (Ditropan)

Relaxes bladder detrusor; treats overactive bladder

Tolterodine / Solifenacin / Darifenacin

Reduce urinary urgency and frequency (M3 blockade)

Dicyclomine (Bentyl)

Relaxes GI smooth muscle; used for irritable bowel syndrome

Rocuronium / Vecuronium / Atracurium / Pancuronium

Non-depolarizing NMJ blockers; cause skeletal muscle paralysis during surgery or intubation

Succinylcholine

Depolarizing NMJ blocker; causes brief paralysis; used for rapid sequence intubation.

Dantrolene

Treats malignant hyperthermia caused by succinylcholine or halothane