engleski

Treatment effects of pilocarpine in patients with xerostomia

Introduction: Pilocarpine, a muscarinic cholinergic sialogogue, has been shown to improve symptoms of oral dryness and to increase salivary output in patients with Sj&oslash ; gren's syndrome and post-irradiation syndrome. The aim of this study was to assess and compare the short-term and long-term effects of orally administered pilocarpine-hydrochloride (PHC) on minor salivary glands and whole saliva production. Materials and methods: Eighteen patients with xerostomia (12 with drug-induced xerostomia, 6 with diagnosed Sj&oslash ; gren’ s syndrome) were included in two consecutive single blind placebo controlled experiments. Experiment 1 comprised 7 repeated salivary flow measurements in time intervals of 15-30 min., from the baseline up to 2 h after single oral administration of 5 mg of PHC. Experiment 2 was designed to evaluate a possible presence of long-term effect of PHC on salivary flow rate. In this experiment, patients were instructed to take 5 mg of PHC, 3 times a day for 7 weeks. Measurements were performed on weekly basis. In both experiments the flow rate of minor salivary glands was measured on lower lip and palate by means of Periotron™ and whole saliva was collected in calibrated test tubes. Dexpanthenol drops were used as placebo, and measurements were performed in the same manner as for PHC in both experiments. Results: Experiment 1 showed that PHC increased salivary output and gave symptomatic relief in every patient. The differences were statistically significant, both compared to baseline and to placebo controls(p=0.01). After increasing salivary flow rate, the action of PHC decreased with time, which was recorded during the observation session. Results of experiment 2 showed that orally administered PHC does not produce long-term increase of salivary flow rate. Conclusion: The treatment with PHC is effectively palliative, but not curative because there is no residual effect in salivary gland stimulation once the drug is discontinued and eliminated.

xerostomia; traetment; pilocarpine

nije evidentirano