Edrophonium (Enlon, Tensilon) and ambenonium (Mytelase) are monoquaternary and bisquaternary ammonium alcohols, respectively. Their positive charge allows them to bind to the anionic site at the reactive center, competitively displacing ACh from the active site without covalent modification of the site. Edrophonium has a very short duration of action, lasting only 5 to 10 minutes, whereas inhibition by ambenonium can last 4 to 8 hours. These drugs have direct agonist activity at nicotinic receptors.
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