Universität zu Köln

Barbe, Anna Greta (2018). Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management. Drugs Aging, 35 (10). S. 877 - 886. NORTHCOTE: ADIS INT LTD. ISSN 1179-1969

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Abstract

Medication-induced xerostomia and hyposalivation will increasingly become oral health issues for older and geriatric patients because of the likely high prevalence of medication intake and polypharmacy, with a complex negative impact on other symptoms such as dysphagia, caries incidence, malnutrition, and quality of life. All healthcare professionals are encouraged to investigate dry mouth symptoms among their patients, since diagnosis can easily be performed within daily clinical practice. This practical article also provides a review of available treatment options, which include medication changes towards products with fewer xerogenic side effects or dose reductions, if possible, as well as multidisciplinary, preventive care-oriented approaches that consider all influencing factors and treatment of the oral symptoms. In addition, several topical agents and saliva substitutes are discussed that may provide symptomatic relief but need to be carefully adapted to each patient's situation in terms of usability and practicability and in the knowledge that therapeutic success varies with each individual. Innovative methods such as intraoral electrostimulation or topical application of anticholinesterase on the oral mucosa are also discussed. The most commonly prescribed pharmaceutical treatment options for dry mouth are pilocarpine (a parasympathomimetic agent with potent muscarinic, cholinergic salivation-stimulating properties) and cevimeline (a quinuclidine analogue with therapeutic and side effects similar to those of pilocarpine). These pharmaceutic treatment options are described in the context of older patients, where the highly prevalent cholinergic side effects, which include nausea, emesis, bronchoconstriction, among others, need to be thoroughly supervised by the healthcare professionals involved. Providing these therapeutic options to patients with medication-induced dry mouth will help improve their oral health and therefore maintain a better quality of life, general health, and well-being.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Barbe, Anna Greta UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-171711
DOI:	10.1007/s40266-018-0588-5
Journal or Publication Title:	Drugs Aging
Volume:	35
Number:	10
Page Range:	S. 877 - 886
Date:	2018
Publisher:	ADIS INT LTD
Place of Publication:	NORTHCOTE
ISSN:	1179-1969
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SALIVARY-GLAND DYSFUNCTION; ORAL MEDICINE VI; PARKINSONS-DISEASE PATIENTS; QUALITY-OF-LIFE; OLDER-ADULTS; DRY MOUTH; SYSTEMIC-DISEASES; WORLD WORKSHOP; RISK-FACTORS; MASTICATORY PERFORMANCE Multiple languages Geriatrics & Gerontology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17171