Pharmacology · single question
Which DRUG causes GINGIVAL HYPERPLASIA/ENLARGEMENT?
Show answer and explanation
Correct answer: A. Calcium channel blockers (e.g., nifedipine, amlodipine)
✓ A) Calcium channel blockers (CCBs) cause gingival enlargement.
Drug-induced gingival enlargement (DIGO) triad: (1) CALCIUM CHANNEL BLOCKERS: nifedipine (most common/severe), amlodipine, verapamil; (2) ANTICONVULSANTS/antiepileptics: phenytoin (Dilantin) — most classic; (3) IMMUNOSUPPRESSANTS: cyclosporine (organ transplant). All three cause fibroblast proliferation and increased collagen production. Mechanism for CCBs: block Ca²⁺ → decreased aldosterone → sodium retention → gingival fibrosis. Management: drug substitution (consult physician) + meticulous oral hygiene + gingivectomy if severe. Plaque exacerbates all forms.
Drug-induced gingival enlargement (DIGO) triad: (1) CALCIUM CHANNEL BLOCKERS: nifedipine (most common/severe), amlodipine, verapamil; (2) ANTICONVULSANTS/antiepileptics: phenytoin (Dilantin) — most classic; (3) IMMUNOSUPPRESSANTS: cyclosporine (organ transplant). All three cause fibroblast proliferation and increased collagen production. Mechanism for CCBs: block Ca²⁺ → decreased aldosterone → sodium retention → gingival fibrosis. Management: drug substitution (consult physician) + meticulous oral hygiene + gingivectomy if severe. Plaque exacerbates all forms.