Pharmacology · patient case question
All of the following reduce salivary flow EXCEPT:
Patient case: Neurology, diuretics and salivary assessment
Scenario: Four items.
Show answer and explanation
Correct answer: D. Cevimeline
- A. Amitriptyline is a tricyclic antidepressant with strong anticholinergic activity and is a classic cause of dry mouth.
- B. Oxybutynin is an antimuscarinic given for overactive bladder; dry mouth is its most common side effect.
- C. Diphenhydramine is a first-generation antihistamine, also markedly anticholinergic.
- D. Correct — this is the exception. Cevimeline is a muscarinic M3 agonist that stimulates salivary secretion. It is prescribed to treat xerostomia in Sjögren syndrome, not to cause it.
Note: Pilocarpine is the other sialogogue in this class. Both are contraindicated in uncontrolled asthma and narrow-angle glaucoma.