Antisialogogues

Antisialogogues are a class of drugs that reduce the flow of saliva. They are also known as anticholinergics or antimuscarinics because they primarily work by blocking the action of acetylcholine, a neurotransmitter that stimulates salivary glands. Saliva production is regulated by the parasympathetic nervous system, and acetylcholine is a key mediator in this process. By inhibiting acetylcholine receptors on the salivary glands, antisialogogues decrease the amount of saliva secreted.

These medications are used to manage conditions characterized by excessive salivation, or sialorrhea. This can include neurological disorders like Parkinson's disease, amyotrophic lateral sclerosis (ALS), and cerebral palsy, where involuntary muscle movements can lead to difficulty swallowing saliva. Antisialogogues are also employed to reduce secretions before certain surgical procedures, particularly in the airway, to prevent aspiration. Additionally, they may be used to counteract the salivary side effects of other medications, such as certain antipsychotics or chemotherapy drugs.

Common antisialogogues include atropine, scopolamine, glycopyrrolate, and benztropine. While effective, these drugs can have various side effects due to their broader anticholinergic effects on other parts of the body. These can include dry mouth, blurred vision, constipation, urinary retention, increased heart rate, and cognitive impairment, particularly in older individuals. The choice of antisialogogue and its dosage are carefully considered based on the patient's condition, potential benefits, and risk of adverse effects.