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Tetramethylammonium is the simplest quaternary ammonium cation, with the chemical formula C4H12N. It is an organonitrogen compound containing a central nitrogen atom substituted with four methyl groups. Tetramethylammonium acts as a cholinomimetic agent, mimicking many effects of acetylcholine. Its pharmacological action primarily involves stimulation and subsequent blockade of neurotransmission in sympathetic and parasympathetic ganglia via depolarization, acting as an agonist at both nicotinic and muscarinic acetylcholine receptors. In smooth muscle, cardiac muscle, and exocrine glands, it stimulates muscarinic receptors; in skeletal muscle it initially causes fasciculations followed by paralysis due to sustained depolarization from nicotinic receptor activation. Tetramethylammonium is rapidly absorbed from the gastrointestinal tract and distributed throughout the body; it is excreted unchanged in urine without metabolic transformation. It has been used experimentally but does not have approved therapeutic indications[1][3][5].
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