Since the existence of a quaternary ammonium group in the structure makes it permanently positively charged and less able to penetrate the blood brain barrier (BBB) by passive transport, the possible use and further structure and inhibition profile refinement of studied compounds, particularly the nonselective compounds can be oriented toward the development of peripherally active cholinesterase inhibitors, which is the primary treatment in early stages and mild forms of myasthenia gravis [47]. This evidence concerns the gene BCHE and myasthenia gravis.