Autonomic nervous system: muscarinic agonists for xerostomia: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Autonomic nervous system: muscarinic agonists for xerostomia

Sample item

A 50-year-old woman with Sjogren syndrome has severe dry mouth that does not respond to saliva substitutes. Which oral drug can increase salivary secretion, and what adverse effect is typical?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Pilocarpine, with sweating

Pilocarpine is a direct muscarinic agonist that stimulates M3 receptors on salivary glands. Because it also stimulates sweat glands, excess sweating is the usual adverse effect. Cevimeline is a related drug.

Option by option

  • A. Ephedrine, with insomnia

    Ephedrine is an adrenergic drug that does not stimulate salivary secretion.

  • B. Neostigmine, with sweating

    Neostigmine is not used for xerostomia and acts indirectly with poor oral absorption.

  • C. Propantheline, with dry eyes

    Propantheline is an antimuscarinic and would worsen the dry mouth.

  • D. Pilocarpine, with sweating (correct)

    Correct. Pilocarpine stimulates glandular M3 receptors and commonly causes sweating.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Pilocarpine, with sweating. Pilocarpine is a direct muscarinic agonist that stimulates M3 receptors on salivary glands.

Why is "Ephedrine, with insomnia" not the answer?

Ephedrine is an adrenergic drug that does not stimulate salivary secretion.

Why is "Neostigmine, with sweating" not the answer?

Neostigmine is not used for xerostomia and acts indirectly with poor oral absorption.

Why is "Propantheline, with dry eyes" not the answer?

Propantheline is an antimuscarinic and would worsen the dry mouth.

What concept does this question test?

It tests Autonomic nervous system: muscarinic agonists for xerostomia in Pharmacology. Because it also stimulates sweat glands, excess sweating is the usual adverse effect. Cevimeline is a related drug.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Autonomic nervous system: muscarinic agonists for xerostomia?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.