Oral conditions and their medications

Question 1

how many pairs of salivary glands are there and name them

Answer 1

3
parotid
submandibular
sublingual

Question 2

what is xerostomia
and state at least 3 important points you know about it

Answer 2

a subjective complaint of dry mouth why may result from a decrease in saliva production

it is a common side effect of numerous prescribed and OTC medicines, but not a specific disease

most frequently reported amongst the elderly

most likely related to patients’ compromised health and using medications to treat those health complications, which then lead ti xerostomia

Question 3

name some commonly used drugs associated with xerostomia (otc or prescribed )

Answer 3

anti-diarrhea meds

antiinflammatory analgesics like NSAIDs

diuretics

decongestants

sedatives

anticholinergics/ antispasmodics

muscle relaxants

antiacne agents….etc

Question 4

anti-cholinergics are the same as antispasmodics, true or false

Answer 4

true

same mechanism of action which is blocking ACh action

Question 5

describe the effects of the autonomous nervous system on saliva production

note that the ANS has sympathetic and parasympathetic divisions

Answer 5

parasympathetic stimulation of the ANS produces an increased fluid volume of serous saliva while

sympathetic stimulation of the ANS produces less volume and more viscous saliva

note that SNS and PNS stimulation have different results in the body apart from in the salivary glands where theu both cause xerostomia

Question 6

what effect eould muscarinic antagonists and sympathomimetics have on saliva production

note that an antagonist inhibits the action or reduces the action of the stimulants or agonists

Answer 6

muscarinic antagonists, since they act on the parasympathetic NS, will reduce the volume of the serous saliva, opposing the effect of parasympathetic stimulation

while sympathomimetics will increase produce more viscous, mucinous saliva, but still with a low volume as they enhance sympathetic stimulation

Question 7

examples of sympathomimetics

Answer 7

Amphetamines

• Appetite suppressants like Semaglutide
• Bronchodilators like albuterol, salbutamol etc
• Decongestants

Question 8

some drugs can cause xerostomia, which drugs are these and how do they cause it

Answer 8

Inhaled medications may produce a sensation of dryness
from their topical effects without actually altering flow rate of saliva

Antihypertensive drugs result in decreased fluid volume – due to the loss of electrolytes from increased urination and dehydration.

Drug induced vasoconstriction of blood vessels supplying
salivary gland will decrease salivary flow rate.

note that some inhalers could actually reduce flow rate of saliva

Question 9

other causes of xerostomia(dry mouth) apart ANS stimulation and certain drugs

Answer 9

Medical conditions - Parkinson disease, diabetes, anemia,
cystic fibrosis, rheumatoid arthritis

• Granulomatous inflammation - tuberculosis, sarcoid, Sjögren
  syndrome, HIV, amyloid
• Dehydration - fever, excessive sweating, vomiting, diarrhea,
  blood loss, burns, smoking, consumption of tea, coffee
• Radiation therapy of head and neck
• Surgical removal of the salivary glands
• Old Age

Question 10

complications associated with xerostomia(mostly with xerostomia as a symptom )

Answer 10

Increased risk of;
* fungal infections caused by Candida species.
* viral infections.
* primary herpes simplex,
* recurrent herpes simplex (herpes labialis),
* herpes zoster
* HIV

Question 11

some self treatments for xerostomia

Answer 11

Frequent sips of cool drinks

Sucking pieces of ice or

Sucking sugar-free fruit pastilles.

Sugar-free (xylitol containing) chewing gum - stimulates
salivation in patients with residual salivary function.

Artificial saliva- neutral pH and contain electrolytes (including
fluoride) to correspond approximately to the composition of
saliva.

Question 12

prescription medication for xerostomia, how it works and when it is prescribed

Answer 12

pilocarpine

works by stimulating serous saliva production, i.e mimicking PNS action

used if dry mouth in sjogren’s syndrome or if xerostomia following irradiation for head and neck cancer

note that pilocarpine only works if the glands are capable of still producing saliva

Sjögren’s syndrome is a chronic autoimmune disease that affects the body’s moisture-producing glands, most notably the eyes and mouth