Substituted cyclohexanes as muscarinic M1 receptor and/or M4 receptor agonists

A compound of the formula (1):

• or a pharmaceutically acceptable salt thereof, wherein:
• p is 0;
• V is selected from a bond, NH, and NH—CH2;
• Q1 is N or CH;
• Q2 is N or CH;
• provided that at least one of Q1 or V comprises a nitrogen atom;
• W is —C(O)OCH2R4 or oxadiazolyl, wherein the oxadiazolyl is optionally substituted with methyl, ethyl, or trifluoromethyl, wherein when W is oxadiazolyl optionally substituted with methyl, ethyl, or trifluoromethyl, then Q2 is CH;
• X1 and X2 are saturated hydrocarbon groups which together contain a total of one to nine carbon atoms and which link together such that the moiety:
• forms a monocyclic ring or bicyclic ring system;
• Q4 is phenyl, wherein the phenyl is optionally substituted with F, methoxy, or methyl;
• or Q4 is pyridyl, wherein the pyridyl is optionally substituted with F, methoxy, or methyl;
• Q5 is cyano;
• and
• R4 is hydrogen or methyl.