Pharmacology · single question
Which medication does NOT cause xerostomia (dry mouth)?
Show answer and explanation
Correct answer: D. Zoledronate (bisphosphonate)
Zoledronate (a bisphosphonate) does not cause xerostomia. Bisphosphonates work on bone metabolism and their primary dental concern is medication-related osteonecrosis of the jaw (MRONJ), not dry mouth. In contrast, the most common causes of xerostomia include: anticholinergic drugs (tricyclics, antihistamines, antipsychotics), diuretics, antihypertensives (especially alpha-blockers), opioids, and benzodiazepines.
- A. ❌ Antihistamines (e.g., diphenhydramine) cause significant xerostomia through anticholinergic mechanisms.
- B. ❌ Many antihypertensives, especially diuretics, ACE inhibitors, and alpha-blockers, contribute to dry mouth.
- C. ❌ Tricyclic antidepressants (e.g., amitriptyline) are among the strongest xerogenic drugs due to their anticholinergic effects.
- D. ✅ CORRECT – Zoledronate (bisphosphonate) does not cause xerostomia; its main dental concern is MRONJ.