Tata Laksana Xerostomia Oleh Karena Efek Penggunaan Amlodipine: Laporan Kasus

Abstract

Introduction: Xerostomia, commonly referred to as dry mouth syndrome, is a result of reduced or absent salivary flow producing mucosal dryness. Patient with xerostomia report symptoms such as mucosal dryness, burning sensation, oral discomforts, alterations in taste, and swallowing become more difficult, the lips are often dry with cracking, peeling, and atrophy. The use of drugs most often caused xerostomia. Several classes of used drugs can cause xerostomia, including antidepressants, anticholinergics, antispasmodics, antihistamines, antihypertensives, sedatives, diuretics, and dan bronchodilators. One of that drugs can causexerostomia is amlodipine as an antihypertensive drug, a class of Calcium channel blockers (CCBs). Objective: to report management of xerostomia caused by the use of amlodipine.Case: 55-year-old female patient came with complaints of dry mouth, thick saliva and difficult to swallow since five months ago. Patients went to the dentist in hospital then the dentist scaling her teeth but complaints have not improved.Patients returned to the dentist in hospital 2 months ago and then the patient was referred to the Rumah Sakit Gigi dan Mulut Universitas Airlangga. The patient had a history of hypertension and taking amlodipine 5 mg once daily since 2 years ago. Sialometry test showed foamy saliva that count 0.03 ml/min. Management: Given chlorine dioxide mouthwash, dry mouth gel, and chewing sugar free gum contain xilitol. Conclusion: management of xerostomia can be done with the use of chlorine dioxide mouthwash and dry mouth gel that can reduce dry mouth symptoms.

Common Precipitating Factors of Xerostomia in Elderly

“…This mechanism affects the whole saliva, which consists of 99% water, and eventually causes xerostomia. 26 Hypnotics is also a drug that is often used by the elderly and can cause side effects of xerostomia. This is consistent with one study, 27 where 53% of respondents had used hypnotics in the previous year, prescription products accounting for 83% (66% benzodiazepines, 11% zopiclone, 4% antidepressants, 2% opioids), while 17% of the products used were over-the-counter (5% herbs, 5% antihistamines, 3% analgesics).…”

Management of Severe Xerostomia and Oral Candidiasis in Patient With Valvular Heart Disease: A Case Report

“…The lemon contained in it stimulates saliva production and gargling activity can stimulate a temporary increase in salivary flow, thereby reducing the risk of infections such as oral candidiasis. 21, [25][26][27] The combination of multiple medications in valvular heart disease patients with long-term use of antibiotics has a high potential for xerostomia in the oral cavity, which can pathogenic transformation of Candida because of its opportunistic nature. Eliminating predisposing factors is one part of therapy, but discontinuation of a causative drug is not always possible.…”

Xerostomia yang diinduksi obat pada Pasien dengan gangguan kecemasan : Laporan Kasus

“…Laju alir saliva normal adalah sebesar 1,0-2,0 ml/menit saat terstimulasi dan 0,3-0,5 ml/menit tanpa stimulasi. 10 Kondisi hiposalivasi terjadi saat laju alir saliva mengalami penurunan hingga <0,7 ml/menit saat terstimulasi dan 0,01-0,1 ml/menit tanpa stimulasi. Salah satu tanda terjadinya hiposalivasi oleh karena penurunan laju alir saliva yaitu xerostomia.…”

“…Xylitol juga dapat mencegah pembentukan plak serta memiliki kemampuan untuk meningkatkan mineralisasi jaringan email. 10,24 Plemons dkk. pada tahun 2015 menyatakan xylitol dapat meningkatkan faktor proteksi pada saliva dengan merangsang laju alir saliva melalui proses fisik yaitu mastikasi dan proses kimiawi melalui rangsangan aroma yang segar.…”