Acetylcholinesterase inhibitors

Acetylcholinesterase inhibitors (AChEIs) are a class of pharmacological agents that inhibit the enzyme acetylcholinesterase. This enzyme is responsible for the breakdown of acetylcholine, a neurotransmitter involved in various physiological processes, including muscle contraction, heart rate regulation, and learning and memory.

Mechanism of Action

AChEIs work by blocking the action of acetylcholinesterase, thereby increasing the concentration of acetylcholine in the synapse. This leads to an enhanced cholinergic effect, which can be beneficial in conditions characterized by decreased cholinergic activity, such as Alzheimer's disease and myasthenia gravis.

Types of Acetylcholinesterase Inhibitors

There are several types of AChEIs, including reversible, irreversible, and quasi-irreversible inhibitors. Reversible inhibitors, such as donepezil and rivastigmine, are commonly used in the treatment of Alzheimer's disease. Irreversible inhibitors, such as organophosphates, are primarily used as pesticides and nerve gases. Quasi-irreversible inhibitors, such as pyridostigmine, are used in the treatment of myasthenia gravis.

Clinical Uses

AChEIs are used in the treatment of various neurological and neuromuscular disorders. In Alzheimer's disease, they help to improve cognitive function and slow disease progression. In myasthenia gravis, they enhance neuromuscular transmission and improve muscle strength. AChEIs are also used in the management of glaucoma, a condition characterized by increased intraocular pressure.

Side Effects

Common side effects of AChEIs include nausea, vomiting, diarrhea, and abdominal pain. These are usually mild and can be managed with dose adjustments. More serious side effects, such as bradycardia and bronchospasm, can occur in some patients, particularly those with underlying heart or lung disease.

See Also

• Neurotransmitter
• Neurology
• Pharmacology