Browse Medications by Drug Class: Cholinergic Agonists

Glaucoma

Cholinergic agonists such as pilocarpine and carbachol are highly effective in lowering intraocular pressure in glaucoma, particularly in open-angle and acute-angle closure cases. These medications work by increasing the outflow of aqueous humor through the trabecular meshwork, preventing damage to the optic nerve. In acute-angle closure glaucoma, pilocarpine can rapidly reduce intraocular pressure, serving as an emergency treatment alongside other interventions to preserve vision.

Xerostomia (Dry Mouth)

Pilocarpine and cevimeline are used to treat xerostomia caused by Sjogren's syndrome or as a side effect of radiation therapy for head and neck cancers. By stimulating salivary glands, these medications improve oral moisture, making it easier to eat, speak, and maintain oral hygiene. They also reduce the risk of dental decay and infections associated with chronic dry mouth.

Urinary Retention

Bethanechol is prescribed for patients with non-obstructive urinary retention, often following surgery or childbirth, or in conditions like neurogenic bladder. It enhances bladder muscle contractions (detrusor muscle) and relaxes the bladder outlet, facilitating urination and preventing complications like urinary tract infections and bladder distension.

Gastrointestinal Disorders

Cholinergic agonists are used to manage conditions like postoperative ileus and atonic bowel, where bowel motility is impaired. By stimulating the smooth muscles of the gastrointestinal tract, these medications help restore normal peristalsis, alleviating bloating, discomfort, and constipation, and promoting digestion.

Adults

Cholinergic agonists are often prescribed to adults managing conditions like glaucoma, dry mouth, or urinary retention. Adults with glaucoma benefit from these medications' ability to reduce intraocular pressure and preserve vision. Patients with xerostomia caused by autoimmune conditions or radiation therapy experience significant relief in oral discomfort and improved oral health. For adults with neurogenic bladder or postoperative urinary retention, these drugs facilitate normal urination, improving quality of life. Additionally, adults with impaired gastrointestinal motility may use cholinergic agonists to restore digestion and alleviate symptoms.

Children

In pediatric cases, cholinergic agonists are used for specific conditions such as congenital glaucoma or neurogenic bladder. Congenital glaucoma, a rare but serious condition, can be managed effectively with pilocarpine to control intraocular pressure and prevent long-term vision damage. For children with neurogenic bladder due to congenital abnormalities or spinal cord injuries, bethanechol can improve bladder function and prevent complications such as recurrent urinary tract infections. Pediatric use requires careful dosing and monitoring to ensure both safety and efficacy.

Seniors

Seniors with conditions like glaucoma, xerostomia, or urinary retention often benefit from cholinergic agonists. These medications are particularly valuable for seniors with chronic dry mouth, as they reduce the risk of dental decay and improve overall comfort. For seniors with glaucoma, cholinergic agonists help manage intraocular pressure, preserving vision and preventing blindness. In cases of neurogenic bladder or postoperative urinary retention, these drugs restore bladder function, reducing the risk of complications. Seniors may require adjusted doses and close monitoring due to increased sensitivity to side effects, such as gastrointestinal discomfort or excessive salivation.