Joe Neary raises the potential risks of multiple drug interactions in
the management of hypertension with more than dual therapy. One of
the side effects of a number of antihypertensive agents is their
(potential) ability to interfere with salivary output. This effect
occurs as a consequence of either an effect on water balance or a
direct pharmacological effect of the drug on the receptors for
salivary output (eg beta adrenergic blockade) or intra-cellular
signalling for salivary output (Ca channel blockers). As a broad
generalisation these drugs do not seem to give too great an effect
when given in isolation but the effects when given in multiple
combinations are at least cumulative.
Reduction in salivary flow can result in significant morbidity in its
own right (difficulties in chewing, swallowing, speech) as well as
potentiating oral problems (oral candidiasis, problems with dental
decay and denture wear).
Is anyone aware of such problems amongst patients, particularly those
on multiple drug therapies?
Angus Walls
Prof. A.W.G. Walls, e.mail [log in to unmask] (Angus Walls)
Restorative Dentistry, telephone (0)191 222 7823
The Dental School, FAX (0)191 222 6137
Framlington Place,
Newcastle upon Tyne.
England.
NE2 4BW
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