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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,