Cevimeline, a parasympathomimetic and muscarinic agonist, affects M1 and M3 receptors. Cevimeline has been shown to treat dry mouth and Sj gren's syndrome. It is also used to reduce Xerostomia symptoms and increase salivary flow in head and neck cancer survivors after radiotherapy.
Cisapride acts directly as a selective agonist of serotonin 5-HT4 receptor with IC50 value of 0.483 μM. And It also acts indirectly as a parasympathomimetic.
Ambenonium chloride tetrahydrate is a salt of ambenonium --- a quaternary ammonium compound with parasympathomimetic activity. It is a cholinesterase inhibitor used in the management of myasthenia gravis. Myasthenia gravis occurs when the body produces antibodies against acetylcholine receptors, and thus inhibits signal transmission across the myoneural junction. Ambenonium chloride is a rapid indirect-acting cholinergic agonist that reversibly blocks the activity of acetylcholinesterase, thereby prevents acetylcholine hydrolysis and prolonging its activity on nicotinic receptors at the neuromuscular junction.
Demecarium Free Base is a quaternary ammonium compound that serves as a long-acting cholinesterase inhibitor with parasympathomimetic activity. When used topically, demecarium inactivates both pseudocholinesterase and acetylcholinesterase, thereby preventing acetylcholine breakdown and increasing acetylcholine activity.