Cholinergic drugs or toxins

Cholinergic drugs or toxins increase acetylcholine activity in the body, and include acetylcholinesterase inhibitors that prevent the breakdown of acetylcholine, and acetylcholine receptor agonists.

Acetylcholinesterase inhibitors cause both muscarinic and nicotinic systemic effects, and include:

• organophosphate and carbamate pesticides
• chemical warfare nerve agents
• donepezil and rivastigmine
• neostigmine and pyridostigmine.

Acetylcholine receptor agonists include:

• nicotinic receptor agonists such as:
  • nicotine in tobacco products, patches, gum, lozenges and e-cigarette liquid
  • nicotine in plants
  • varenicline
  • neonicotinoid insecticides
• muscarinic receptor agonists—Amanita muscaria mushrooms, and Clitocybe and Inocybe mushroom species.