Betanechol

This drug is similar to carbachol in all parameters, i.e., pharmacokinetics, pharmacodynamics and clinical indications; it has a better advantage over carbachol because it has fewer side effects as a result as lack of nicotinic actions.

Contra indications to the use of choline esters

1. Bronchial asthma because they may induce bronchial constriction and increase bronchial secretions
2. Hyperthyroidism because of the danger of inducing atrial fibrillation
3. Peptic ulcer disease because of the increase in gastric acid secretion
4. Coronary insufficiency because the hypertension produced will further compromise coronary blood flow
5. Mechanical intestinal and urinary outlet obstruction

CHOLINERGIC ALKALOIDS

1. Those with chiefly nicotinic actions include nicotine, lobeline etc.
2. Those with chiefly muscarinic actions include muscarine, pilocarpine, etc.