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Bethanechol

Structure related to Acetylcholine, acetate is replaced by carbamate & choline is methylated, thus it is carbomyl beta methyl choline.

It has no nicotinic actions

Muscarinic actions are prominent on eye, GIT & urinary bladder

Prolonged duration of action because is more resistant to hydrolysis.

Duration of action is one hour.

Therapeutic uses:

1. Post operative gastric distension

2. Paralytic ileus

3. Bladder atonia

4. Megacolon

It is given subcutaneously in 5 mg dose. Neostigmine is also given for these conditions (15 mg oral, 0.5-1 mg subcutaneously)

Mechanism of action is like carbamates.

Toxicity includes bronchospasm, it does not enter CNS.

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