直接作用和间接作用胆碱受体兴奋剂有许多不同之处。直接作用的胆碱受体兴奋剂实际上是毒蕈碱受体，或者它们是直接作用的胆碱受体兴奋剂是可逆和不可逆的烟碱受体。其次，指导作用的胆碱受体兴奋剂是在PNS的神经效应连接处模拟ACh的药物，而直接作用是ACh代谢的抑制剂。第三，用于直接作用的机制是它们通常偶联于cGMP增加的G蛋白，这可能进一步导致IP3的活化。 DAG级联进一步打开与Ca 2+通道有关的平滑肌，并且IP 3导致肌浆网Ca 2+的释放（Blount等314-321）。间接作用拟胆碱药物的作用机理是阻断乙酰胆碱的酶促水解，有助于增加Ach的局部浓度。直接作用胆碱受体兴奋剂通常用于其毒性的目的，也用于吸烟的停止，而间接作用胆碱模拟药物用于治疗青光眼，重症肌无力和神经肌肉的逆转膜。
There are a number of differences in the direct acting and indirect action cholinoceptor stimulant. While direct acting cholinoceptor stimulant are actually the muscarinic receptors or they are the nicotinic receptors in direct acting that cholinoceptor stimulant is reversible and irreversible. Secondly, directing acting cholinoceptor stimulant are the drugs which mimic ACh at neuroeffector junctions of PNS while the in-direct are the ones which are the inhibitors of ACh metabolism. Thirdly, the mechanism which is used for the direct acting is that they are generally coupled to the G proteins in which there is an increase in cGMP that may further lead to the activation of the IP3. DAG cascade which further opens the smooth muscles related to the Ca2+¬¬¬channels and IP¬¬3 lead to the release of Ca2+¬¬¬¬ from sarcoplasmic reticulum (Blount et al 314-321). The mechanism used in Indirect-acting Cholinomimetic Drugs is that they do the blocking of the enzymatic hydrolysis of acetylcholine and helps in the increase of the local concentration of Ach levels. The direct acting cholinoceptor stimulants are generally used for the purpose of its toxicity and are also used as for the cessation of smoking while Indirect-acting Cholinomimetic Drugs are used in the treatments of the diseases such as Glaucoma, Myasthenia Gravis, and reversal of the neuromuscular membrane.