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XEROSTOMIA: FINDING A SOLUTION AT THE PHARMACY

25th February 2019 0

Xerostomia is a term that refers to the subjective sensation of dry mouth due to a decrease in or absence of saliva caused by salivary gland dysfunction. 

Why do medicines cause xerostomia? 

Saliva is produced by the salivary glands, which are in turn regulated by the autonomic nervous system—sympathetic and parasympathetic. 
There are over 500 medicines that can stimulate or inhibit the sympathetic and parasympathetic systems, thereby affecting saliva production. Among these are the following groups of drugs
1. Anticholinergic agents
2. Diuretic agents
3. Antihypertensive medications
4. Antidepressants and antipsychotics
5. Anxiolytic and sedative agents
6. Antihistamines
7. Analgesic agents
8. Muscle relaxants
9. Others:
a. Anorexigens
b. Anti-acne
c. Anticonvulsants
d. Antiparkinson agents
e. Bronchodilators 

Solutions for xerostomia 

Different solutions for xerostomia currently exist. 
- General measures such as drinking water frequently, eating cured cheeses, fruits and vegetables, avoiding dry, spicy and sticky foods, using a humidifier at night, using lip balms to moisturise the lips and avoiding irritants such as tobacco, coffee or alcohol. 
- Artificial saliva moisturises and protects from irritants. It acts quickly but is short-lasting. 
- Drugs used to stimulate the production of saliva in patients with very severe xerostomia, i.e. those suffering from Sjögren's syndrome or undergoing head and neck radiation therapy. 
- Oral hygiene products that also fight xerostomia are specific products that moisten the oral cavity and/or stimulate salivation, while preventing oral disease. They must be devoid of irritants and alcohol and have a low abrasivity index. Suitable for 100% of the population and for patients with xerostomia of any cause. 

The pharmacist’s advice 

Pharmaceutical advice is how pharmacists put their knowledge into practice by recommending the best solutions for their patients. 
Pharmaceutical advice should focus on improving the quality of life of the patient, which in turn will result in greater customer loyalty. 
To offer the best pharmaceutical advice, we recommend following several specific steps, and not leaving it to improvisation. The first thing we must do is to plan for the kind of patients we have and how often they come into our pharmacy, assess which pathologies are the most common and what associated problems these may have. 
It is then advisable to write action protocols for each type of patient, considering what the situations are that we will find in each of the cases and pathologies, age ranges, how to detect patients, taking into account that it may be the affected person directly or someone else who goes to the pharmacy on their behalf, such as their partner or a family member. 
Training the staff at the pharmacy on the protocols is very important, so that the whole team acts in the same manner and is familiar with the protocols. 
In the case of xerostomia, we must be aware of those groups at risk, since between 20% and 40% of the population suffers from this disorder: 
- Polymedication
- Pregnancy
- Elderly
- Anxiety and/or depression
- Cancer
- Diabetes
- Tobacco/alcohol
- Sjogren's syndrome
- Public speakers 
As indicated above, good pharmaceutical advice can increase patient loyalty. In the case of xerostomia, this gain in loyalty may even be seen immediately. Thus, in patients with a dry mouth, difficulty swallowing and/or talking - such as cancer patients - recommendation of effective xerostomia products will lead to immediate improvement in their quality of life by allowing them to swallow and/or speak with greater ease. 
Xeros Dentaid offers two different ranges: one to moisturise the mouth, and another to stimulate natural saliva production. The safety and efficacy of both ranges are scientifically backed. 
The Xeros moisturising range keeps the oral mucosa moisturised. It comes in the form of a topical moisturising gel, a toothpaste and a mouthwash to be used as part of daily oral hygiene. 
The Xeros saliva stimulating range offers products that are easy to use away from home and includes tablets, spray and chewing gum. 
 
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