Classification of Anticholinergic Drugs

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Chapter: Essential pharmacology : Anticholinergic Drugs And Drugs Acting On Autonomic Ganglia

Conventionally, anticholinergic drugs are those which block actions of ACh on autonomic effectors and in the CNS exerted through muscarinic receptors. Though nicotinic antagonists also block certain actions of ACh, they are generally referred to as ‘ganglion blockers’ and ‘neuromuscular blockers’.



           1.   Natural alkaloids Atropine, Hyoscine (Scopolamine).

          2. Semisynthetic derivatives Homatropine, Atropine methonitrate, Hyoscine butyl bromide, Ipratropium bromide, Tiotropium bromide.

    3.   Synthetic compounds

           a) Mydriatics: Cyclopentolate, Tropicamide

    b)  Antisecretoryantispasmodics:


         i) Quaternary compounds: Propantheline, Oxyphenonium, Clidinium, Pipenzolate methyl bromide, Isopropamide, Glycopyrrolate.

ii) Tertiary amines: Dicyclomine, Valethamate, Pirenzepine.


           c)    Vasicoselective: Oxybutynin, Flavoxate, Tolterodine.

           d) Antiparkinsonian: Trihexyphenidyl (Benzhexol), Procyclidine, Biperiden.


In addition, many other classes of drugs, i.e. tricyclic antidepressants, phenothiazines, antihistamines and disopyramide possess significant antimuscarinic actions.


The natural alkaloids are found in plants of the solanaceae family. The levoisomers are much more active than the dextroisomers. Atropine is racemic while scopolamine is lhyoscine.


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