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Current Opinion on Drug-induced Oral Reactions - Coggle Diagram
Current Opinion on Drug-induced Oral Reactions
Salivary Glands
Saliva is protective through a cleansing action as well as through
the antimicrobial action of various salivary components such as
mucinhistatins
mucin
have the ability to trap water thus protecting the mucosa from injury through desiccation
lysozyme
lactoferrin
function of specific antibodies
The composition of saliva is altered in various diseases such as
inflammatory bowel disease
diabetes
periodontitis
organophosphate poisoning
function can be affected by a variety of drugs that can produce xerostomia or ptyalism
Xerostomia may be due to both the reduced salivary flow rate and to a decrease in salivary calcium and phosphate concentration caused by such drugs as amphetamines.
Salivary hypersecretion is usually caused by physiological factors such as menstruation or early pregnancy
Common oral manifestations resulting from decreased salivary flow
increased dental caries
fungal infections
bacterial infections
aphthous lesions
dysphagia
Systemic drug therapy can also produce pain and swelling of the salivary glands
Drugs with the potential to affect salivary glands
Drugs that can causes
sialorrhea
Nitrazepam
Lithium
Organophosphaxes
Levodopa
Nifedipine
Alprazolam
Mercurial salts
Ambroxol
Drugs that have potencial to causes
swelling or pain in salivary glands
Catecholamine inhalation
Chlorhexidine
Methyldopa
Naproxen
Nifedipine
Warfarin
Sulfonamides
Drugs and chemicals implicated in
xerostomia
Benzodiazepines
Beta blockers
Cyclosporine
Insulin
Antihistamines
Nicotine
Opioids
Oral Motor Disorders
medications and illegal drugs produce a motor response that is classified better as an unspecified extrapyramidal syndrome (EPS) reaction that have three presentations
dystonia
consist of involuntary, tonic contractions of skeletal muscles
akathisia
occur as a subjective experience of motor restlessness
parkinsonism
manifest themselves as tremor, rigidity, and akinesia, which shows as a slowness in initiating motor tasks
When a medication or drug induces a dystonic EPS reaction, it typically involves the muscles of the head, face, and jaw that produce spasm, grimacing, tics, or trismus
The general rule for treatment is to withdraw the offending medication in the hope the dyskinesia or dystonic reaction goes away
If the suspected medication cannot be stopped or if the motor hyperactivity is severe, diphenhydramine or benztropine are administered intravenously or intramuscularly to treat the motor hyperactivity.
diazepam have been shown to be effective for recurrent neuroleptic-induced dystonic reactions
List of drugs reported to induce oral motor disorders
Promethazine
Selective serotonin reuptake inhibitors
Prochlorperazine
Metoclopramide
Antipsychotics
Amphetamine derivates
Taste Disorders
Many drugs induce abnormalities of taste
hypogeusia
decreased sensitivity in taste perception
ageusia
total loss of the ability to taste
dysgeusia
distortion in perception of the correct taste of a substance
Drugs with potential to cause dysgeusia
Aspirin
Captopril
Cocaine
Enalapril
Penicillamine
Terbinafine Topiramate
Ritonavir
Rifabutin
Indomethacin
Drugs with potential to cause ageusia
Acyclovir
Amoxicillin
Acetaminophen
Aspirin
ACEIs
Azitromycin
Ketorolac
Lidocaine
Metformin
Ritonavir
Sulfonamides
Halitosis
is offensive breath resulting from poor oral hygiene, dental or oral infections, ingestion of certain foods, use of tobacco, and some systemic diseases and medications
Drugs causing xerostomia may indirectly cause or aggravate this problem
Drugs that can induce halitosis
Cytotxic drugs
Chloral hydrate
Dimethyl sulphoxide
Disulfiram
Nitrites and nitrates
Succimer
Oral Infections
Many types of systemic drug therapy can alter oral flora and, therefore, predispose the mouth to bacterial or fungal infection
Superficial candidia infections usually have a characteristic clinical appearance, and diagnosis is often based on clinical findings
Drugs with potential to cause oral candidiasis
Antineoplastics
Cephalosporine
Antibiotics
Coticosteroids
Griseofulvin
Omeprazole
Oral contraceptives
Immunosuppressives
Alveolar Osteitis
the most common complication following dental extraction and has been defined as an inflammation of the alveolus
The use of oral contraceptives has been associated with
a significant increase in the frequency of dry sockets after removal of impacted lower third molars
treatment
analgesic symptomatic accompanied by antinflamatory treatment and antibiotics
antiseptic intra-alveolar pastes
Angioedema
sudden occurrence of subcutaneous or submucosal swelling
allergic angioedema
penicillin and sulfa drugs can cause it
non- allergic angioedema
ACEIs can cause it
treated by a conservative clinical approach
artificial ventilation, glucocorticoids, and antihistamines
Drugs that can cause angioedema
ACEIs
Estrogens
Ketoconazole
NSAIDd
Penicillin
Tacrolimus
Cheilitis
abnormal condition of the lips characterized by inflammation and cracking of the skin
Drugs with potential to cause cheilitis
Ritonavir
Streptomycin
Gold compounds
Tetracycline
Bulsufan
Vitamina A
Clofazimine