bethanechol (Urecholine)
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Introduction
Tradename: Urecholine.
Indications
- treatment of acute post-operative & post-partum non- obstructive urinary retention & neurogenic atony
- treatment & prevention of urinary dysfunction due to phenothiazines
- chronic refractory heartburn, including vagotomized & antrectomized patients
Dosage
Tabs: 5, 10, 25, 50 mg
Caution:
- do NOT give IV or IM, severe cholinergic reactions may occur
Pharmacokinetics
- GI effects seen within:
- 60-90 minutes of oral ingestion
- 10-15 minutes of SC injection
- does not cross the blood-brain barrier
elimination via liver
Adverse effects
- oral (< 1%), subcutaneous (1-10%)
- hypotension, cardiac arrest, flushed skin, abdominal cramps, nausea/vomiting, diarrhea, bronchial constriction, sweating, salivation, vasomotor response
- other[2]
Drug interactions
- quinidine & procainamide may antagonize cholinergic effects of bethanecol
- coadministration of ganglionic blocking agents may result in severe hypotension & abdominal symptoms
- other cholinergic agents or cholinesterase inhibitors may cause additive effects & increased toxicity
Mechanism of action
- acetylcholine analog with relatively pure muscarinic receptor agonist activity[4]
- causes increase in tone of the detrusor muscle
- stimulates gastric motility & increases gastric tone
- restores rhythmic peristalsis
More general terms
Additional terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ 2.0 2.1 Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 The Pharmacological Basis of Therapeutics, 8th ed. Gilman et al, eds. Permagon Press/McGraw Hill pg 142, 143