Side effects of Pilocarpine are A/E
**Core Concept**
Pilocarpine is a muscarinic receptor agonist used to treat glaucoma and benign prostatic hyperplasia. It works by increasing the outflow of aqueous humor from the eye and relaxing the smooth muscle in the prostate.
**Why the Correct Answer is Right**
Pilocarpine's side effects are primarily related to its muscarinic agonist activity. It can cause salivation, sweating, and bronchial secretions due to stimulation of the parasympathetic nervous system. Additionally, it can cause miosis (pupil constriction) and accommodation spasms. These effects are mediated through the activation of M3 muscarinic receptors in the eye and other tissues.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because pilocarpine does not cause significant systemic vasodilation as a side effect. Its primary effects are localized to the eye and smooth muscle in the prostate.
**Option B:** This option is incorrect because pilocarpine can actually cause pupil constriction (miosis), not dilation. Its muscarinic agonist activity leads to the constriction of the pupil.
**Option C:** This option is incorrect because pilocarpine does not typically cause significant central nervous system depression or sedation as a side effect. Its primary effects are related to its muscarinic agonist activity in the periphery.
**Option D:** This option is incorrect because pilocarpine can actually cause bradycardia (slow heart rate) due to its stimulation of the parasympathetic nervous system.
**Clinical Pearl / High-Yield Fact**
When prescribing pilocarpine, it's essential to monitor patients for signs of systemic muscarinic effects, such as salivation, sweating, and bronchial secretions. These effects can be mitigated by administering the medication at bedtime and advising patients to avoid driving or operating heavy machinery.
**Correct Answer: D. Bradycardia**