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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/03/31 12:00:24」(JST)

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Bethanechol is a parasympathomimetic choline carbamate that selectively stimulates muscarinic receptors without any effect on nicotinic receptors. Unlike acetylcholine, bethanechol is not hydrolyzed 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).

Uses

Bethanechol alleviates dry mouth^[1] 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 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 mechanical obstruction is ruled out as a possible cause.

Its potential benefit in the treatment of cerebral palsy has been investigated.^[2] Bethanechol is a powerful cholinergic agent which does not cross the blood - brain barrier and may have powerful nootropic properties in enhancement of neural signaling and processing speed as well.

Atropine is given preoperatively to prevent voiding of the bowel/bladder during surgery, Bethanechol is then given postoperatively to revert this action.^[3]

Contraindications

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

References

^ Gorsky, Meir; Epstein, Joel B.; Parry, Jamie; Epstein, Matthew S.; Le, Nhu D.; Silverman, Sol (2004-02-01). "The efficacy of pilocarpine and bethanechol upon saliva production in cancer patients with hyposalivation following radiation therapy". Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 97 (2): 190–195. doi:10.1016/S107921040300564X. ISSN 1079-2104. PMID 14970777.
^ Carter WJ (September 2008). "Unexpected benefits of bethanechol in adults with cerebral palsy". Med. J. Aust. 189 (5): 293. PMID 18759732.
^ Obied, Hassan (2011). Cholinergic Pharmacology. CSU.

(Benavides-Haro et al. (2003)). The cholinomimetic agent bethanechol activates IK(ACh) in feline atrial myocytes. Naunyn-Schmiedederg's Arch Pharmacol. 368:309-315

UpToDate Contents

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3. 頭頸部癌の初期治療中の合併症のマネージメントおよび予防 management and prevention of complications during initial treatment of head and neck cancer
4. 寝汗がみられる患者に対するアプローチ approach to the patient with night sweats
5. 女性における慢性尿閉 chronic urinary retention in women

English Journal

Vagal afferent fibres determine the oxytocin-induced modulation of gastric tone.

Holmes GM, Browning KN, Babic T, Fortna SR, Coleman FH, Travagli RA.SourcePenn State College of Medicine;
The Journal of physiology.J Physiol.2013 May 27. [Epub ahead of print]
Oxytocin (OXT) inputs to the dorsal vagal complex (DVC; nucleus tractus solitarius, NTS, dorsal motor nucleus of the vagus, DMV, and area postrema) decrease gastric tone and motility. Our first aim was to investigate the mechanism(s) of OXT-induced gastric relaxation. We demonstrated recently that v
PMID 23587885

Effect of hyoscine butylbromide (Buscopan® ) on cholinergic pathways in the human intestine.

Krueger D, Michel K, Allam S, Weiser T, Demir IE, Ceyhan GO, Zeller F, Schemann M.SourceHuman Biology, Technische Universität München, Freising, Germany.
Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society.Neurogastroenterol Motil.2013 May 19. doi: 10.1111/nmo.12156. [Epub ahead of print]
BACKGROUND: Hyoscine butylbromide (HBB, Buscopan® ) is clinically used to treat intestinal cramps and visceral pain. Various studies, mainly on animal tissues, suggested that its antimuscarinic action is responsible for its spasmolytic effect. However, functional in vitro studies with human tissue
PMID 23682729

Cholinergic muscarinic receptor activation augments murine intestinal epithelial cell proliferation and tumorigenesis.

Peng Z, Heath J, Drachenberg C, Raufman JP, Xie G.SourceDivision of Gastroenterology and Hepatology, Veterans Affairs Maryland Health Care System, University of Maryland School of Medicine, Baltimore, MD, USA. gxie@medicine.umaryland.edu.
BMC cancer.BMC Cancer.2013 Apr 24;13:204. doi: 10.1186/1471-2407-13-204.
BACKGROUND: Previously, we showed that M3 muscarinic receptor (M3R; gene name Chrm3) deficiency attenuates murine intestinal neoplasia, supporting the hypothesis that muscarinic receptors play an important role in intestinal tumorigenesis.METHODS: To test this hypothesis, in the present study we tre
PMID 23617763

Japanese Journal

末梢性ムスカリン型コリン作動薬bethanecholによるScopolamineのマウス移所運動促進作用に対する耐性形成の阻止

KURIBARA Hisashi
東京福祉大学・大学院紀要 4(2), 107-113, 2014-03-25
… The combined administration of SCP + bethanechol (BET: 0.01, 0.03, 0.1 and 0.3 mg/kg s.c.), a peripheral muscarinic cholinergic drug, resulted in sensitization, although the single treatment with 0.03-0.1 mg/kg of BET did not modify the ambulation-increasing effect of SCP at the first administration. …
NAID 120005486685

末梢性ムスカリン型コリン作動薬bethanecholによるScopolamineのマウス移所運動促進作用に対する耐性形成の阻止

栗原久
東京福祉大学・大学院紀要 = Bulletin of Tokyo University and Graduate School of Social Welfare 4(2), 107-113, 2014-03
NAID 40020184718

ウシガエル胃粘膜におけるアンモニアのｐｅｐｓｉｎｏｇｅｎ分泌に対する影響

菅野朝
杏林医学会雑誌 42(2), 53-62, 2011
… 刺激物質にはbethanecholおよびアンモニア（10mM，30mM，50mM NH4Cl）を用いた。 … 「結果」1．bethanechol投与後，PGは有意な上昇を認めた。 …
NAID 130001055557

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bethanechol - patient information, description, dosage and directions. Buy Bethanechol: Helps the Bladder Contract in Pets - VetRxDirect Bethanechol Chloride Tabs - 10mg (per tabs) (Manufacture may vary) Bethanechol Chloride Tabs - 5mg (per tabs) (Manufacture may vary) Bethanechol (Urecholine) 25mg Tablet

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Bethanechol
Systematic (IUPAC) name
	2-(Carbamoyloxy)-N,N,N-trimethylpropan-1-aminium
Clinical data
Trade names	Urecholine
AHFS/Drugs.com	monograph
MedlinePlus	a682849
Pregnancy; category	US: C (Risk not ruled out); ;
Routes of; administration	Oral, subcutaneous
Identifiers
CAS Number	674-38-4
ATC code	N07AB02 (WHO)
PubChem	CID 2370
IUPHAR/BPS	297
DrugBank	DB01019
ChemSpider	2280
UNII	004F72P8F4
KEGG	C06850
ChEBI	CHEBI:3084
ChEMBL	CHEMBL1482
Synonyms	2-[(aminocarbonyl)oxy]- N,N,N-trimethyl- 1-propanaminium
Chemical data
Formula	C7H17N2O2
Molar mass	161.221 g/mol
	SMILES O=C(OC(C)C[N+](C)(C)C)N ;
	InChI InChI=1S/C7H16N2O2/c1-6(11-7(8)10)5-9(2,3)4/h6H,5H2,1-4H3,(H-,8,10)/p+1 ; Key:NZUPCNDJBJXXRF-UHFFFAOYSA-O ;
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