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OBMP Exam 2 > Modulation of Salivary Gland Function > Flashcards

Modulation of Salivary Gland Function Flashcards

1
Q

Acute or chronic reduced salivary flow may be due to:

A

Mechanical blockage, dehydration, emotional stress, infection of the salivary glands, local surgery, avitaminosis, diabetes, anemia, connective tissue disease, congenital factors, radiation therapy, Sjogren’s syndrome, medications.

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2
Q

Drug induced xerostomia is a concern because:

A
  1. older adults take more prescription and non-prescription drugs
  2. Over 400 medications are implicated in causing xerostomia
  3. oral health impact of xerostomia is consequential
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3
Q

Drug categories implicated in causing xerostomia include:

A

sympathomimetics, diuretics, cardiovascular meds, anticholinergics, tricyclic antidepressants, antihistamines, psychotropic agents, antiparkinson agents, antineoplastic drugs, muscle relaxants.

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4
Q

Herbal preparations that can induce xerostomia:

A

St. John’s wort, Gingko Biloba

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5
Q

Factors contributing to increased caries susceptibility:

A

-decreased titers of antimicrobial substances and loss of mineralizing components and shift to more cariogenic bacteria.

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6
Q

Caries in xerostomic pts most likely to occur near:

A

gingival margins and on exposed root surfaces.

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7
Q

Xerostomia presents clinically with:

A

Periodontal problems, altered taste sensation, mouth soreness

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8
Q

Xerostomia is associated with:

A

oral pain, increased oral infections, difficulty speaking, chewing and swallowing.

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9
Q

Xerostomia tx is important to:

A

keep mouth moist, prevent caries, candida infections, and provide palliative relief.

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10
Q

Palliative measures for xerostomia include:

A
  • sipping water
  • avoiding mouth rinses with alcohol
  • ice melting
  • limit caffeine
  • humidifying sleeping area
  • vaseline on lips
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11
Q

Rx Saliva Substitute:

A

Sodium Carboxymethylcellulose 0.5%

  • 8 fl oz
  • rinse prn
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12
Q

Commercial saliva substitutes:

A

Xero-lub, Salivart, Moi-Stir, Orex

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13
Q

Rx fluoride therapy:

A

Stannous fluoride gel 0.4%

  • 24 ml
  • 5-10 mins/day in carrier (5-10 drops)
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14
Q

What should be considered if poorly tolerated taste or ceramic restorations present?

A

Use of neutral pH sodium fluoride gel 1%

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15
Q

Rx neutral sodium fluoride gel:

A
  • 1%
  • 24 ml
  • 1 drop/tooth in tray, 5 mins daily
  • Avoid rinsing/eating 30 mins.
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16
Q

No more than ____ NaF should be dispensed in one container.

A

264 mg

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17
Q

24 ml is approx:

A

2 week supply of gel

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18
Q

Antifungal Rx

A

Nystatin (topical) or Fluconazole (systemic)

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19
Q

Saliva stimulants like _____ may temporarily stimulate salivary flow.

A

sugarless gum or dissolving mints

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20
Q

Parasympatholytics

A

decrease saliva secretion

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21
Q

Parasympathomimetics

A

increase saliva secretion

22
Q

meds that decrease saliva

A
  • Propantheline
  • Methantheline
  • Glycopyrolate
  • Atropine
23
Q

meds that increase saliva secretion

A
  • Pilocarpine
  • Bethanechol
  • Cevimelin
24
Q

A muscarinic receptor agonist that is FDA approved

A

Pilocarpine

25
Q

Pilocarpine, Bethanechol, and Cevimeline are

A

Parasympathomimetic drugs

26
Q

Doses of pilocarpine

A

Initial divided doses of 15 mg/day in 5 mg doses, can be up to 30 mg/day

27
Q

Pilocarpine side effects on glands

A

significant increase in parotid, submandibular, and sublingual secretions

28
Q

Pilocarpine effect depends on

A

residual salivary gland function

29
Q

T or F: Pilocarpine has no significant effect on blood pressure/heart rate

A

T

30
Q

Pilocarpine contraindications:

A

asthma and complete loss of salivary gland function

31
Q

Side effects of Pilocarpine:

A

sweating, chills, nausea, and dizziness

32
Q

Does prophylactic use of pilocarpine decrease reduction in severity of xerostomia…

A

Maybe?

33
Q

Used in divided doses of 75-200 mg/day without complaints of GI upset and a reduced tendency for sweating:

A

Bethanechol

34
Q

Treatment of Sjogren’s syndrome: 30 mg tid

A

Cevimeline

35
Q

Pilocarpine activates the _____________ receptor in the _______ membrane of the _________ cell to form saliva

A

muscarinic, basal, acinar

36
Q

Parasympatholytic drugs should be used for

A

transient modulation

37
Q

Parasympatholytic drugs are

A

antisialogoges

38
Q

Competitive antagonists for the muscarinic receptors therefore will reduce salivary gland secretion

A

Parasympatholytic

39
Q

Contraindications of parasympatholytic drugs:

A

glaucoma, cardiovascular disease, and prostate hypertrophy

40
Q

Side effects of parasympatholytic drugs

A

Blurred vision, drowsiness, tachycardia, decreased intestinal or bladder smooth muscle action.

41
Q

T or F: Side effects of parasympatholytics can occur after single dose used in dental practice.

A

T

42
Q

Propatheline, methantheline, and glycopyrolate are examples of

A

Parasympatholytic drugs

43
Q

Atropine like drug that may be useful in inhibition of salivation before a dental procedure

A

Propantheline

44
Q

Dose of propantheline

A

Adults: 15 mg 30-40 mins before appt. Second tab can be given if needed.
-Children should be half dose

45
Q

Alternative drug that has same effects as propantheline but thought to have more intense side effects:

A

Methantheline

46
Q

Dosage of Methantheline

A

50 mg or 100 mg before appt

47
Q

A quaternary amine of the anticholinergic class similar to propantheline but greater per mg potency and a longer duration of action:

A

Glycopyrolate

48
Q

Has less sedative effect and CNS effect than scopolamine and has a better therapeutic index than atropine as a antisialogog:

A

glycopyrolate

49
Q

Cardiac side effects are considered less frequents than for atropine

A

Glycopyrolate

50
Q

T or F: I added this card so there would be exactly 50 cards in this set.

A

T

OBMP Exam 2 (4 decks)

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