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Pharmacology · single question

All of the following medications can reduce salivary flow (cause xerostomia) EXCEPT:

  1. Pilocarpine (a cholinergic/muscarinic agonist that actually INCREASES salivary flow, used specifically to treat xerostomia in conditions like Sjögren's syndrome)
  2. Amitriptyline
  3. Diphenhydramine
  4. Atropine
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Correct answer: A. Pilocarpine (a cholinergic/muscarinic agonist that actually INCREASES salivary flow, used specifically to treat xerostomia in conditions like Sjögren's syndrome)

Pilocarpine is a muscarinic (cholinergic) receptor agonist that stimulates salivary gland secretion, INCREASING salivary flow — it's used therapeutically to treat xerostomia (e.g., in Sjögren's syndrome or post-radiation xerostomia), making it the opposite of a sialogogue-reducing drug. Amitriptyline (anticholinergic tricyclic antidepressant), diphenhydramine (anticholinergic antihistamine), and atropine (a classic anticholinergic) all genuinely reduce salivary flow.

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