The drugs of this group reproduce the effects of the mediator of the parasympathetic nervous system – acetylcholine, due to its interaction with m-cholinergic receptors. m-Cholinergic receptors are localized in all organs receiving parasympathetic innervation, at the end of the postganglionic parasympathetic fibers. m-Cholinergic receptors are heterogeneous. Interaction with the m1-cholinergic receptors of the central nervous system is accompanied by the occurrence of excitement, and with the m1-receptors of the intramural parasympathetic plexuses of the gastrointestinal tract – an increase in the secretion of the gastrointestinal glands.
The effect of activation of m2-cholinergic receptors localized in the heart is manifested in a decrease in heart rate and other functions of the heart, incl. conductivity.
The most numerous are the effects of m-cholinomimetics, due to the excitation of the m3-cholinergic receptors of smooth muscles and exocrine glands. They cause bronchospasm and bronchorhea, increased secretion of gastric glands, increased tone of the gastrointestinal tract, bile and urinary tract. The action of aceclidine on the gastrointestinal tract can be used for intestinal and bladder atony.
The most relevant aspect of the pharmacodynamics of m-cholinomimetics is their effect on intraocular pressure: they improve the outflow of intraocular fluid and, thereby, lower intraocular pressure. This effect finds application in the treatment of intraocular hypertension and glaucoma.
Below is a list of m-cholinomimetics:

  • Pilocarpine (Pilocarpinum)
  • Pilocarpine (Pilocarpinum)