Clinical use of cholinomimetic agents: a review.
BACKGROUND
There are many agents in clinical use that manipulate central nervous system levels of epinephrine, dopamine, and serotonin. However, development of pharmacological options to manipulate central acetylcholine systems has lagged behind because of poor penetration of the blood-brain barrier and significant peripheral nervous system side effects. Newer agents have demonstrated some efficacy in the management of behavioral and cognitive side effects in Alzheimer's disease, and preliminary data in traumatic brain injury suggest acetylcholine esterase inhibitors may play a significant role in the treatment of this patient population as well.


CONCLUSIONS
In this article, the basic neuroanatomy and pharmacology of the central acetylcholine system are reviewed, along with agents currently available for clinical use.
Blount
Philip J
PJ
Charlotte Institute of Rehabilitation, 1100 Blythe Boulevard, Charlotte, NC 28203, USA.
Nguyen
Conner D
CD
McDeavitt
James T
JT
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy*; D001930:Brain Injuries / Q000175:diagnosis / Q000188:drug therapy*; D002219:Carbamates / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D003566:Cytidine Diphosphate Choline / Q000008:administration & dosage; D000077265:Donepezil; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007189:Indans / Q000008:administration & dosage; D007275:Injections, Intravenous; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010277:Parasympathomimetics / Q000008:administration & dosage*; D048448:Phenylcarbamates; D010830:Physostigmine / Q000008:administration & dosage; D010880:Piperidines / Q000008:administration & dosage; D000068836:Rivastigmine; D012720:Severity of Illness Index; D013619:Tacrine / Q000008:administration & dosage; D016896:Treatment Outcome
D002219:Carbamates; D007189:Indans; D010277:Parasympathomimetics; D048448:Phenylcarbamates; D010880:Piperidines; D013619:Tacrine; D003566:Cytidine Diphosphate Choline; D000077265:Donepezil; D010830:Physostigmine; D000068836:Rivastigmine