Effects of the thiazide diuretic bendrofhimethiazide on salivary flow rate and composition

Abstract

Nederfors T, Twetman S, Dahlof C: Effects of the thiazide diuretic bendroflumethiazide on salivary flow rate and composition. Scand J Dent Res 1989; 97: 520-7.Abstract -Thiazide diuretics are among the first-line alternatives in the treatment of primary hypertension. The effects of thiazide treatment on salivary production are, however, little stud3ed and the results so far available are not decisive. The ainn of the present study was to evaluate and compare salivary flow rate and composition during treatment with the thiazide diuretic bendrofiumethiazide in a low dose (2.5 mg o.d.) and placebo. The study was performed with a randomized, double-blind, cross-over design (2 x 2 wk) in 34 healthy volunteers. The treatment periods were separated by a wash-out period of 2 wk. Resting and stimulated whole saliva was sampled three times daily on scheduled days during the treatment periods. Flow rate was assessed for resting saliva, whereas flow rate, pH,, buffer capacity, amount of total proteins and concentrations of sodium, potassium, calcium, phosphate and magnesium were measured for sdmulated whole saliva. No efFect of bendroflumethiazide on the resting salivary flow rate could be detected, while the stimulated flow rate was significandy reduced by about 10% during the thiazide treatment. The total sodium output was significantly decreased by approximately 30%, without any detectable change in total potassium output. All other variables of stimulated whole saliva studied were not different from placebo. It is concluded that treatment with bendroflumethiazide in a low dose significantly reduces the stimulated whole salivary flow rate and total sodium output in healthy volunteers.

Effects of the β-adrenoceptor Antagonists Atenolol and Propranolol on Human Parotid and Submandibular-Sublingual Salivary Secretion

“…In the study by Streckfus et al, some of the elderly hypertensives were taking thiazide diuretics, alone or in combination with p-blockers, which makes these results less conclusive. Treatment of healthy volunteers with at least one thiazide diuretic, bendroflumethiazide, has been demonstrated to cause a decrease in human whole saliva secretion rate (Nederfors et al, 1989).…”

“…We have previously reported on the effects of the thiazide diuretic bendroflumethiazide on whole saliva secretion and oral mucosal friction as well as the effects of the f-adrenoceptor antagonists atenolol and propranolol on whole saliva secretion in healthy human volunteers (Nederfors et al, 1989Nederfors and Dahlbf, 1992).…”

Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion

“…Medications, and especially antidepressants, antianxiety agents, antihypertensives, diuretics, and antihistamines, are the most common cause of both hyposalivation and xerostomia (Sreebny and Schwartz, 1997). They may exert specific effects on different receptor systems on the salivary glands, such as the muscarinic cholinergic receptor, or induce compositional changes via their action on the salt and water transport and balance (Clemmesen, 1988; Nederfors, Twetman and Dahlöf , 1989). Radiation therapy of head and neck cancer induces irreversible damage to the salivary gland tissue resulting in hypofunction (Valdez et al , 1992; see earlier article in this series by Nagler).…”

Diagnosing, managing, and preventing salivary gland disorders

“…Any drug that inhibits neurotransmitter binding to acinar membrane receptors, or that perturb ion transport pathways, may also adversely affect the quality and quantity of salivary output. These medications include tricyclic antidepressants, sedatives and tranquilizers, antihistamines, antihypertensives (α and β blockers, diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors), cytotoxic agents, anti‐Parkinsonian, and antiseizure/spasmodic drugs (Nederfors, Twetman and Dahlof, 1989; Nederfors et al , 1994, 1995; Streckfus et al , 1994; Hunter and Wilson, 1995; Loesche et al , 1995; Nederfors, 1996; Field et al , 1997; Pajukoski et al , 1997; Sreebny and Schwartz, 1997; Bergdahl and Bergdahl, 2000). Therefore, patients taking one or more drugs with antisialogogue sequelae should be followed carefully for developing signs and symptoms of salivary disorders.…”