Bethanechol

Bethanechol (be-Than-e-kol [key]) is a parasympathomimetic choline ester that selectively stimulates muscarinic receptors without any effect on nicotinic receptors. Its chemical structure is 2-((aminocarbonyl)oxy)-N,N,N-trimethyl-1-propanaminium. Unlike acetylcholine, bethanechol is not hydrolyzed by cholinesterase and will therefore have a long duration of action.

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Bethanechol is sometimes given orally or subcutaneously to treat urinary retention resulting from general anesthetic or diabetic neuropathy of the bladder, or to treat gastrointestinal atony (lack of muscular tone). The muscarinic receptors in the 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 obstruction is ruled out as a possible cause.

Use of bethanechol, as well as all other muscarinic receptor agonists, is contraindicated in patients with asthma, coronary insufficiency, peptic ulcers, and incontinence. The parasympathomimetic action of this drug will exacerbate the symptoms of these disorders.

Bethanechol is sold under the brand names Duvoid (Roberts), Myotonachol (Glenwood), and Urecholine (Merck Frosst).

Sources

• Katzung, Bertram G. Basic and Clinical Pharmacology, 9th ed. (2004). ISBN 0-07-141092-9
• Brenner, G. M. (2000). Pharmacology. Philadelphia, PA: W.B. Saunders Company. ISBN 0-7216-7757-6
• Canadian Pharmacists Association (2000). Compendium of Pharmaceuticals and Specialties (25th ed.). Toronto, ON: Webcom. ISBN 0-919115-76-4