Drugs Affecting Salivary Flow Flashcards Preview

GI- Week 1 > Drugs Affecting Salivary Flow > Flashcards

Flashcards in Drugs Affecting Salivary Flow Deck (20):
1

What are the parasympathomimetics used for xerostomia?

Cevimeline (Evoxac)

Pilocarpine (Pilocar)

2

T or F. Saliva production is a parasympathetic-mediated phenomenon

T.

3

What drugs have anticholinergic effects?

Antihistamines such as diphenhydramine and chlorpheniramine

Decongestants such as pseudoephedrine

AntiHTNs such as methyldopa, CCBs, and metoprolol

Anticholinergics such as atropine and scopolamine

4

What are some causes of temporary xerostomia?

short term anticholinergic drug use (e.g. antihistamines),

viral infection (e.g. mumps),

dehydration, anxiety

5

What are some endocrine disorders associated with xerostomia?

DM and hypothyroidism

6

What are some infections associated with xerostomia?

HIV, Hep C

7

What are some neurological disorders associated with xerostomia?

Parkinson's disease and Bell's palsy

8

What are some genetic conditions associated with xerostomia?

CF, Down syndrome, celiac disease

9

Other causes of xerostomia?

head and neck radiation

graft vs. host disease

Bone marrow transplant

10

Notes about Sjogren syndrome

This is an autoimmune disease marked by destruction of tear and salivary glands producing enlarged parotids, dry eyes, and mouth (among other things). Treatment/management usually involves saliva substitutes, DMARDs, and emphasis on tooth care

11

What are some potential consequences of xerostomia?

-increased risk of mucosal and tongue lesions

risk of candidiasis, dental caries, and other oral infection

taste alteration

12

Describe the mechanism of salivary production

Ach binds to Gq coupled M3 muscarinic Ach receptors which caused phospholipase C to generate IP3 to promote Ca2+ release. Ca2+ release activates apical Cl- channels and basolateral K+ channels. Efflux of Cl- into the acinar lumen draws Na+ across the cells, and the osmotic gradient generates fluid secretion

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14

Describe Cevimeline (Evoxac)

this is partially-selective M3-receptor agonist (with some M1 activity) on the lacrimal and salivary gland epithelium

15

When should Cevimeline never be used?

asthma, closed angle glaucome or iritis

16

How is pilocarpine different from cevimeline?

it does not show any receptor sub-types selectivity, acting upon al muscarinic receptors regardless of location

17

What is another use of amifostine besides nephro-protection with use of cisplatin by acting as a free-radical scavenger?

it can also be used for radioprotection of the neck and head during radiation therapy to protect the salivary (parotid) glands and prevent xerostomia

18

What are some drugs that can be used for hypersalivation?

PO glycopyrrolate, an anticholinergic 

botox injections or scopolamine patches

19

What are some other uses of scopolamine?

prevention of N/V with motion sickness

reduction in spastic states in parkinsonism

induce pupil dilation

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