Which of the following is a systemic side effect of parasympathomimetics used for glaucoma management?

• A. Ocular irritation
• B. Uveitis
• C. Salivation, vomiting, diarrhea, sweating
• D. Bradycardia

Answer: (C)

Systemic effects come from the same muscarinic receptor stimulation these glaucoma meds cause in the eye, but when a bit of the drug reaches the rest of the body it triggers widespread parasympathetic activity. That means secretions from glands and gut activity ramp up. The classic systemic picture is increased salivation, sweating, and GI symptoms like vomiting and diarrhea. Ocular irritation is a local, surface effect from the eye drops and isn’t a systemic issue. Uveitis isn’t a typical systemic adverse effect, and while bradycardia can occur with cholinergic overstimulation, the combination of salivation, sweating, vomiting, and diarrhea best represents the systemic side effects these drugs can cause.