Muscarinic Antagonist - Comparison Table

Comparison Table

Substance	Trade names	Mechanism	Clinical use	Adverse effects
Atropine (D/L-Hyoscyamine)		non-selective antagonism, CNS depression	in anaesthesia anticholinesterase poisoning bradycardia antispasmodic in gastrointestinal hypermotility	urinary retention xerostomia blurred vision
Scopolamine (L-Hyoscine)	Scopace, Transderm-Scop, Maldemar, Buscopan	non-selective antagonism, CNS depression	as atropine motion sickness	as atropine sedation
Hydroxyzine	Vistaril, Atarax
Ipratropium	Atrovent and Apovent	non-selective antagonism, without any mucociliary excretion inhibition.	in asthma and bronchitis
Tropicamide		short acting non-selective antagonism, CNS depression	produce mydriasis and cycloplegia in diagnostics	may cause ocular hypertension
Pirenzepine		M1 receptor-selective antagonist inhibits gastric secretion	in peptic ulcer (not much anymore)	(fewer than non-selective ones)
Diphenhydramine	Benadryl, Sominex	Non-selective antagonism in the central nervous system, blood vessels and smooth muscle tissues	for extrapyramidal symptoms from typical and atypical antipsychotic medications antihistamine sleep aid antiparkinson agent management of asthma symptoms	*Sedation, dry mouth, constipation, urinary retention
Dimenhydrinate	Dramamine	Combination of diphenhydramine with a methylxanthine salt	motion sickness
Dicyclomine
Flavoxate	Urispas		Urinary bladder antispasmodic
Oxybutynin	Ditropan		overactive bladder urge incontinence
Tiotropium	Spiriva		Chronic obstructive pulmonary disease
Cyclopentolate		short acting non-selective antagonism, CNS depression	produce mydriasis and cycloplegia in diagnostics	may cause ocular hypertension
Atropine methonitrate		non-selective antagonism, blocks transmission in ganglia. Lacks CNS effects	antispasmodic in gastrointestinal hypermotility
Trihexyphenidyl/Benzhexol	Artane	Targets the M1 Muscarinic receptor	Parkinson's disease	Drug at relative dose has 83% activity of atropine, thus has the same side-effects
Tolterodine	Detrusitol, Detrol
Solifenacin	Vesicare	Competitive muscarinic acetylcholine receptor antagonist	overactive bladder (OAB) Urgency (urge incontinence)
Darifenacin	Enablex	Selective for M3 receptors	Urinary incontinence	Few side effects
Benzatropine	Cogentin	Reduces the effects of the relative central cholinergic excess that occurs as a result of dopamine deficiency.	Parkinson's disease
Mebeverine	Colofac, Duspatal, Duspatalin	A muscolotropic spasmolytic with a strong and selective action on the smooth muscle spasm of the gastrointestinal tract, particularly of the colon.	Irritable bowel syndrome in its primary form (e.g. Abdominal Pain, Bloating, Constipation, and Diarrhea). Irritable bowel syndrome associated with organic lesions of the gastrointestinal tract. (e.g. diverticulosis & diverticulitis, etc.).	skin rashes
Procyclidine		Antimuscarinic	Drug-induced parkinsonism, akathisia and acute dystonia; Parkinson disease; and Idiopathic or secondary dystonia	Overdose produces confusion, agitation and sleeplessness that can last up to or more than 24 hours. Pupils become dilated and unreactive to light. Tachycardia (fast heart beat), as well as auditory and visual hallucinations

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