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Guerra et al. J Transl Genet Genom 2022;6:304-21      https://dx.doi.org/10.20517/jtgg.2022.08                                                                                      Page 316



                                                        Name: Glycopyrrolate                                                                                            Mechanistic genes: CHRM1, CHRM2, CHRM3,
                                                        IUPAC Name: Pyrrolidinium, 3-[(cyclopentylhydroxyphenylacetyl)oxy]-1,1-dimethyl-, bromide                       CHRM4, CHRM5
                                                        Molecular Formula: C H BrNO  Molecular Weight: 398.33 g/mol                                                     Metabolic genes: Substrate: CYP1A2, CYP2B6,
                                                                           19  28   3
                                                        Mechanism: Blocks action of acetylcholine at parasympathetic                                                    CYP2C9, CYP2D6,CYP2C18, CYP2C19, CYP3A4
                                                        sites in smooth muscle, secretory glands, and CNS                                                               Transporter genes: SLC22A2, SLC47A1
                                                        Effect: Anticholinergic agents, antimuscarinics/antispasmodics
                                                        Name: Trihexyphenidyl                                                                                           Pathogenic genes: PARK2
                                                        IUPAC Name: 1-Piperidinepropanol,α-cyclohexyl-α-phenyl                                                          Mechanistic genes: CHRM1, CHRM2, CHRM3,
                                                        Molecular Formula: C H NO                                                                                       CHRM4, CHRM5
                                                                           20  31
                                                        Molecular Weight: 301,46 g/mol
                                                        Mechanism: Exerts direct inhibitory effect on parasympathetic nervous system. It also has a relaxing effect
                                                        on smooth musculature, exerted both directly on muscle itself and indirectly through parasympathetic nervous system
                                                        (inhibitory effect)
                                                        Effect: Antiparkinsonian agents, anticholinergic agents
                                                        Name: Atropine                                                                                                  Mechanistic genes: CHRM1, CHRM2; CHRM3,
                                                        IUPAC Name: Benzeneacetic acid, α-(hydroxymethyl)-8-methyl-8-azabicyclo[3.2.1]oct-3-yl ester, endo-(–)          CHRM4, CHRM5, CHRNA4, CHRNB2, FOS, GLRA1,
                                                        Molecular Formula: C H NO                                                                                       PTGS2, TP53
                                                                           17  23  3
                                                        Molecular Weight: 289.37 g/mol                                                                                  Transporter genes: ABCB11
                                                        Mechanism: Blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and CNS.   Pleiotropic genes: ACHE, CES1
                                                        Increases cardiac output, dries secretions. Reverses the muscarinic effects of cholinergic poisoning
                                                        Effect: Mydriatics, anticholinergic agents, antimuscarinics/antispasmodics, antidote
                                                        Name: Domperidone                                                                                               Pathogenic genes: DRD2, DRD3
                                                        IUPAC name: 2H-Benzimidazol-2-one, 5-chloro-1-[1-[3-(2,3-dihydro-2-oxo-1H-benzimidazol-1-yl)propyl]-4-piperidinyl]-1,3-  Mechanistic genes: DRD2, DRD3
                                                        dihydro-                                                                                                        Metabolic genes: Substrate: CYP3A5 (major),
                                                        Molecular Formula: C  H ClN O                                                                                   CYP3A7, CYP3A4 (major), CYP1A2 (minor), CYP2B6
                                                                           22  24  5  2
                                                        Molecular weight: 425.91 g/mol                                                                                  (minor), CYP2C8 (minor), CYP2D6 (minor), CYBs
                                                        Mechanism: Has peripheral dopamine receptor blocking properties. Increases esophageal peristalsis; lowers       (major)
                                                        esophageal sphincter pressure, gastric motility, and peristalsis; and enhances gastroduodenal coordination, therefore   Transporter genes: ABCB1
                                                        facilitating gastric emptying and decreasing small bowel transit time
                                                        Effect: Prokinetic agents, dopamine antagonist
                                                        Name: Baclofen                                                                                                  Mechanistic genes: GABBR1, GABBR2, CXCR4, CFTR
                                                        IUPAC name: Butanoic acid, 4-amino-3-(4-chlorophenyl)-                                                          Transporter genes: ABCC9, ABCC12, SLC28A1
                                                        Molecular Formula: C H ClNO
                                                                           10
                                                                              12
                                                        Molecular weight: 213.66 g/mol
                                                        Mechanism: Inhibits the transmission of mono/polysynaptic reflexes at the spinal cord level, possibly by hyperpolarization of
                                                        primary afferent fiber terminals
                                                        Effect: GABA-derivative skeletal muscle relaxants





                                                                                                                                    [77]
                          pathway do not appear to significantly modify parameters related to clinical improvement .


                          Xerostomia
                          The first line of treatment for xerostomia is to employ local therapies (artificial saliva, sialogogues), avoiding the use of systemic medications (pilocarpine) as
                          the first choices due to their common negative effects. Side effects include blurred vision, bronchoconstriction, hiccup, sweating, hypotension, bradycardia,
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