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Pilocarpine Treatment of Salivary Gland Hypofunction and Dry Mouth (Xerostomia)

Pilocarpine Treatment of Salivary Gland Hypofunction and Dry Mouth (Xerostomia) Abstract We studied the effects of pilocarpine hydrochloride, a parasympathomimetic agent, on major salivary gland output and subjective responses in 31 patients with salivary hypofunction. Pilocarpine hydrochloride (5-mg capsules, three times daily) was given for 5 months and a placebo was randomly assigned for 1 month in a double-blind fashion. Objective measurements of major salivary gland output, subjective impressions of oral moisture, treatment-related side effects, and a number of physiologic measures were assessed monthly. Pilocarpine significantly increased salivary output in 21 of the 31 patients. Subjective improvement in the feeling of oral dryness, speaking, chewing, and swallowing were reported by 27 individuals. Side effects, while common, generally were mild and tolerable. There were no significant alterations in cardiovascular or other physiologic measures. We conclude that pilocarpine is an effective and safe treatment for salivary gland hypofunction and xerostomia in selected patients. The increase in major gland output provides beneficial natural secretions and relief of oral dryness. (Arch Intern Med. 1991;151:1149-1152) References 1. Fox PC, van der Ven PF, Sonies BC, Weiffenbach JM, Baum BJ. Xerostomia: evaluation of a symptom with increasing significance . J Am Dent Assoc. 1985;110:519-525. 2. Silverman S Jr. Oral defenses and compromises: an overview . NCI Monogr. 1990;9:17-19. 3. Talal N. Overview of Sjögren's syndrome . J Dent Res. 1987;66:672-674. 4. Mandel ID. The role of saliva in maintaining oral homeostasis . J Am Dent Assoc. 1989;119:298-304. 5. Taylor P. Cholinergic agonists . In: Gilman AG, Goodman LS, Gilman A, eds. The Pharmacologic Basis of Therapeutics. 6th ed. New York, NY: Macmillan Publishing Co Inc; 1980:96-98. 6. Buckley JP. Modern Dental Materia Medica, Pharmacology and Therapeutics . Philadelphia, Pa: Blakiston's Son & Co; 1910:217-224. 7. Fox PC, van der Ven PF, Baum BJ, Mandel ID. Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction . Oral Surg. 1986;61:243-248.Crossref 8. Greenspan D, Daniels TE. Effectiveness of pilocarpine in postradiation xerostomia . Cancer. 1987;59:1123-1125.Crossref 9. Carlson AV, Crittenden AL. The relationship of ptyalin concentration to the diet and to the rate of secretion of saliva . Am J Physiol. 1910;26:169-177. 10. Heft MW, Baum BJ. Unstimulated and stimulated parotid salivary flow rate in individuals of different ages . J Dent Res. 1984;63:1182-1185.Crossref 11. Tylenda CA, Ship JA, Fox PC, Baum BJ. Evaluation of submandibular salivary flow rate in different age groups . J Dent Res. 1988;67:1225-1228.Crossref 12. Tabak LA, Levine MJ, Mandel ID, Ellison SA. Role of salivary mucins in protection of the oral cavity . J Oral Pathol. 1982;11:1-17.Crossref 13. Shern RJ, Fox PC, Cain JL, Li S-H. A method for measuring the flow of saliva from the minor salivary glands . J Dent Res. 1990;69:1146-1149.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Pilocarpine Treatment of Salivary Gland Hypofunction and Dry Mouth (Xerostomia)

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References (15)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400060085014
Publisher site
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Abstract

Abstract We studied the effects of pilocarpine hydrochloride, a parasympathomimetic agent, on major salivary gland output and subjective responses in 31 patients with salivary hypofunction. Pilocarpine hydrochloride (5-mg capsules, three times daily) was given for 5 months and a placebo was randomly assigned for 1 month in a double-blind fashion. Objective measurements of major salivary gland output, subjective impressions of oral moisture, treatment-related side effects, and a number of physiologic measures were assessed monthly. Pilocarpine significantly increased salivary output in 21 of the 31 patients. Subjective improvement in the feeling of oral dryness, speaking, chewing, and swallowing were reported by 27 individuals. Side effects, while common, generally were mild and tolerable. There were no significant alterations in cardiovascular or other physiologic measures. We conclude that pilocarpine is an effective and safe treatment for salivary gland hypofunction and xerostomia in selected patients. The increase in major gland output provides beneficial natural secretions and relief of oral dryness. (Arch Intern Med. 1991;151:1149-1152) References 1. Fox PC, van der Ven PF, Sonies BC, Weiffenbach JM, Baum BJ. Xerostomia: evaluation of a symptom with increasing significance . J Am Dent Assoc. 1985;110:519-525. 2. Silverman S Jr. Oral defenses and compromises: an overview . NCI Monogr. 1990;9:17-19. 3. Talal N. Overview of Sjögren's syndrome . J Dent Res. 1987;66:672-674. 4. Mandel ID. The role of saliva in maintaining oral homeostasis . J Am Dent Assoc. 1989;119:298-304. 5. Taylor P. Cholinergic agonists . In: Gilman AG, Goodman LS, Gilman A, eds. The Pharmacologic Basis of Therapeutics. 6th ed. New York, NY: Macmillan Publishing Co Inc; 1980:96-98. 6. Buckley JP. Modern Dental Materia Medica, Pharmacology and Therapeutics . Philadelphia, Pa: Blakiston's Son & Co; 1910:217-224. 7. Fox PC, van der Ven PF, Baum BJ, Mandel ID. Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction . Oral Surg. 1986;61:243-248.Crossref 8. Greenspan D, Daniels TE. Effectiveness of pilocarpine in postradiation xerostomia . Cancer. 1987;59:1123-1125.Crossref 9. Carlson AV, Crittenden AL. The relationship of ptyalin concentration to the diet and to the rate of secretion of saliva . Am J Physiol. 1910;26:169-177. 10. Heft MW, Baum BJ. Unstimulated and stimulated parotid salivary flow rate in individuals of different ages . J Dent Res. 1984;63:1182-1185.Crossref 11. Tylenda CA, Ship JA, Fox PC, Baum BJ. Evaluation of submandibular salivary flow rate in different age groups . J Dent Res. 1988;67:1225-1228.Crossref 12. Tabak LA, Levine MJ, Mandel ID, Ellison SA. Role of salivary mucins in protection of the oral cavity . J Oral Pathol. 1982;11:1-17.Crossref 13. Shern RJ, Fox PC, Cain JL, Li S-H. A method for measuring the flow of saliva from the minor salivary glands . J Dent Res. 1990;69:1146-1149.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Jun 1, 1991

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