Question 1

How do you remember Pilocarpine?

Accepted Answer

Pilocarpine breaks down as PILO = pile o' + CARPINE = carp. Separate Pilocarpine into PILO (sounds like pile o') and CARPINE (sounds like carp). Picture a pile o' (PILO) carp (CARP) - a bunch of fish flopping everywhere and making the whole room wet. That wet scene is the cholinergic picture: pilocarpine is a direct muscarinic agonist that causes salivation, sweating, and tearing.

Question 2

What class of drug is Pilocarpine?

Accepted Answer

Pilocarpine is a Muscarinic Agonist • Direct Cholinergic • Glaucoma.

Question 3

How is Pilocarpine tested on the USMLE?

Accepted Answer

A direct muscarinic agonist not broken down by acetylcholinesterase. It contracts the ciliary muscle to open aqueous outflow and causes miosis, lowering intraocular pressure. It is first-line for acute angle-closure glaucoma.

Question 4

A 68-year-old man presents with a severely painful red eye, blurred vision with halos around lights, and a fixed mid-dilated pupil. Tonometry shows markedly elevated intraocular pressure. He is treated with topical pilocarpine. By which mechanism does it lower his intraocular pressure?

Accepted Answer

B - Pilocarpine is a muscarinic agonist. In the eye it contracts the ciliary muscle (opening the trabecular meshwork to boost aqueous outflow). A describes beta-blockers and alpha-2 agonists, which cut aqueous production; D is carbonic anhydrase inhibitors like acetazolamide. C is backwards - pilocarpine causes miosis, not mydriasis; dilating the pupil would worsen angle-closure.

Pilocarpine

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