Other Choline Esters

Carbachol is not destroyed by cholinesterase, its actions are most pronounced on the bladder and gastrointestinal tract, so that the drug has been used to stimulate these organs, e.g. after surgery. This use (also of bethanecol, below) is now much diminished and, for example, catheterisation is preferred for bladder atony. Carbachol is stable in the gut, hence it can be given orally; it is extremely dangerous if given i.v., but can be safely administered s.c.

Bethanechol resembles carbachol in its actions but is some 10-fold less potent (it differs by a single p-methyl group) and has no significant nicotinic effects at clinical doses.

1 Harris M et al 1943 Archives of Neurology and Psychiatry 50: 304.

2 Cohen L H et al 1944 Archives of Neurology and Psychiatry 51: 171.

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