Many middle- aged and older patients are on multiple medications (poly pharmacy) that induce dry mouth because of synergic effects of these drugs (even with low anticholinergic effects). Furthermore, the patients who took one or more drugs were two times more at the risk of xerostomia than those who didn’t take any medication. In the study by Villa, xerostomia was almost 3 times more in adults undergoing medication than those who didn’t take any medication. In a systematic review in USA, xerostomia was found as a secondary effect in 80–100% of prescribed drugs. Xerostomia, the most common adverse drug reaction affecting the oral cavity, is associated with over 500 drugs. The aim of this study is to review the literature and highlights the more common and significant adverse oral consequences of drug therapy. Typically, these changes occur within weeks or months after taking the drugs and may be symptomatic or asymptomatic. Adverse drug events in the oral cavity have a variety of clinical presentation. Drug factors include route of administration, duration, dose, and variation in metabolism. Patients’ risk factors include gender (more common in women), age (frequently in neonates and the elderly), underlying disease (more common in patients with hepatic disease and renal failure), and genetics. The presence and severity of ADRs are related to patient and drug-dependent factors. Since many patients take prescriptions and over-the-counter medications, dentists should be aware of drug-related problems in the orofacial regions. Finally, reactions occurring after withdrawals are referred to as type F. Delayed adverse reactions of the drug are labeled as type D, and those reactions appearing after many years of treatment are defined as type E. For example, adverse effects may depend on the duration of the treatment in addition to dose (type C). Furthermore, recently other types of drug reactions have been described. Most of these reactions are immune-mediated side effects like hypersensitivity responses. Type B reactions are also divided into two subgroups, immunological and non-immunological reactions. About 20% of ADRs are caused by an unpredictable reaction to drug which are known as type B reactions and are usually non-dose-related. Type A primary reactions are characterized as an abnormal reaction due to excessive action of the primary pharmacology of the drug such as oral mucosal bleeding after the use of anticoagulant agents, whereas a type A secondary reaction is a secondary pharmacology of the drug such as dysgeusia during the use of anti hypertention drugs. Pharmacology can be divided into two subgroups as primary and secondary. They are dose- dependent and predictable and are also associated with the pharmacology of drug. Type A reactions represent about 80% of the cases. ADRs have been classified into two types. An adverse drug reaction (ADR) is defined by WHO as “a response to a drug which is noxious and unintended, and which occurs at dose normally used in man for the prophylaxis, diagnosis, therapy of disease or for the modification of physiological function”. Different drugs that patients take to prevent or control disease expose them to the risk of developing adverse reactions.
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