<prompt> All are the pharmacologic therapeutic options for achalasia, EXCEPT:NitratesBeta blockersBotulinum toxinSildenafil  <response>: Pharmacologicals therapies are usually ineffective. They can be used as a temporary measures. The agents used are: 1. Nitrates 2. Calcium channel blockers 3. Botulinum toxin 4. Sildenafil- phosphodiesterase inhibitors, effectively decrease LES pressure. Botulinum toxin, injected into the LES under endoscopic guidance, inhibits acetylcholine release from nerve endings and improves dysphagia in about 66 of cases for at least 6 months Ref: Harrison, Edition-18, Page-2432 