Drug that inhibits the action of acetylcholine at nicotinic acetylcholine receptors
A nicotinic antagonist is a type of anticholinergic drug that inhibits the action of acetylcholine (ACh) at nicotinic acetylcholine receptors. These compounds are mainly used for peripheral muscle paralysis in surgery, the classical agent of this type being tubocurarine,[1] but some centrally acting compounds such as bupropion, mecamylamine, and 18-methoxycoronaridine block nicotinic acetylcholine receptors in the brain and have been proposed for treating nicotine addiction.[medical citation needed]
Comparison
Mechanism
Antagonist
Preferred receptor
Clinical use
Ganglionic blocking agents
Hexamethonium
Ganglion type
None[2]
Mecamylamine
Ganglion type
Trimethaphan
Ganglion type
Rarely used for blood pressure decrease during surgery[2]
Nondepolarizing neuromuscular blocking agents
Atracurium
Muscle type
Muscle relaxant in anaesthesia[2]
Doxacurium
Muscle type
Mivacurium
Muscle type
Pancuronium
Muscle type
Muscle relaxant in anaesthesia[2]
Tubocurarine
Muscle type
Discovered in arrow poison it was the first pheripheral muscle relaxant. Rarely used since 1980s.[2]
Vecuronium
Muscle type
Muscle relaxant in anaesthesia[2]
Depolarizing neuromuscular blocking agents
Succinylcholine*
Muscle type
Centrally acting nicotinic antagonists
18-Methoxycoronaridine
α3β4
Bupropion
α3β4. α4β2, α1β1γδ
Antidepressant (NDRI)
Hydroxybupropion
α3β4. α4β2, α1β1γδ
Antidepressant (NDRI). Metabolite of bupropion.
Threohydrobupropion
α3β4.
Antidepressant (NDRI). Metabolite of bupropion.
Dextromethorphan
α3β4. α4β2, α7
Common over the counter antitussive.
Dextrorphan
α3β4. α4β2, α7
Metabolite of dextromethorphan; no accepted medical uses.
3-Methoxymorphinan
α3β4
Secondary metabolite of dextromethorphan; not used in medical practice. Unknown medical efficacy.
Note: Succinylcholine is a nicotinic agonist. See neuromuscular blocking agents page for details on the mechanism of action.
^P. Taylor (1990). In Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th Ed., (A. G. Gilman et al., Eds.), pp. 166-186, New York: Pergamon Press.
^ abcdefRang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-07145-4. Page 149
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