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  • Bethanechol is a synthetic direct-acting cholinergic agonist with a specificity for muscarinic receptors. It is less prone to destruction by cholinesterases and thus displays a long half-life compared to acetylcholine. Its primary pharmacological effects are on the GI and GU systems and is therapeutically used to promote mictruition in those with atonic bladders.
Pharmacological Effects and Therapeutic Uses
  • GI System: Bethanechol enhances GI Motility. Previously it was used to treat intestinal atony but other agents have replaced it for this use.
  • GU System: Bethanechol stimulates the detrusor muscle of the bladder, promoting mictruition. Consequently, bethanechol has been used to treat atonic bladder, potentially as a result of neurogenic bladder.
Adverse Effects
  • Overview
    • Most of the adverse effects of this drug are predictable consequences of muscarinic receptor stimulation.
  • Cardiovascular: Hypotension, bradycardia
  • Respiratory: Bronchoconstriction as such contraindicated in asthma and COPD
  • GI: Diarrhea due to increased GI secretions and abdominal cramping likely from increased GI Motility
  • Glands: Increased sweating yielding diaphoresis.