Bethanechol is a parasympathomimetic choline carbamate that selectively stimulates muscarinic receptors without any effect on nicotinic receptors. Unlike acetylcholine, bethanechol is not hydrolysis by cholinesterase and will therefore have a long duration of action. Bethanechol is sold under the brand names Duvoid (Roberts), Myotonachol (Glenwood), Urecholine (Merck Frosst), and Urocarb (Hamilton). The name bethanechol refers to its structure as the carbamate of beta-methyl choline.
Medical uses
Bethanechol alleviates dry mouth
and is sometimes given orally or subcutaneously to treat urinary retention
resulting from general anesthetic, diabetic neuropathy of the bladder, or a side effect of
antidepressants; or to treat gastrointestinal
Atony. The muscarinic receptors in the
Urinary bladder and gastrointestinal tract stimulate contraction of the bladder and expulsion of
urine, and increased gastrointestinal motility, respectively. Bethanechol should be used to treat these disorders only after mechanical obstruction is ruled out as a possible cause.
Its potential benefit in the treatment of cerebral palsy has been investigated.
Atropine is given preoperatively to prevent voiding of the bowel/bladder during surgery; then, bethanechol is given postoperatively to revert this action.
Contraindications
Use of bethanechol, as well as all other muscarinic receptor agonists, is contraindicated in patients with
asthma, coronary insufficiency,
, intestinal obstruction and
hyperthyroidism. The parasympathomimetic action of this drug will exacerbate the symptoms of these disorders.
External links
