• Journal of Oral Medicine and Pain
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• 제42권3호
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• pp.72-80
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• 2017

Purpose: Pilocarpine as a salivation stimulant in pill form has mostly been used to relieve oral dryness for xerostomic patients but its use may often be limited due to variable side effects from systemic absorption. Therefore, the purpose of this study was to investigate the effects of pilocarpine mouthwash on salivation according to the variable concentration and duration for healthy volunteers. Related adverse effects and subjective assessment on its effects on salivation were also examined. Methods: This study was performed as placebo-controlled, double-blind, randomized clinical trial. Thirty healthy volunteers (male=23, mean age=22.2 years) were randomly allocated to 6 groups with the different concentration of pilocarpine mouthwash (placebo, 0.1%, 0.5%, 1.0%, 1.5%, and 2.0%). The whole experiment consisted of 3 sessions according to the duration of mouthwash, i.e., 1, 3, and 5 minutes with the mean wash-out period ${\geq}2$ days between the sessions. Unstimulated whole saliva was collected before and after gargling with a mouthwash. Results: Salivation of the higher concentration groups ${\geq}1%$ significantly increased than those of lower concentration group. The application period of mouthwash did not cause any changes of salivary flow rate at the higher concentrations ${\geq}1.0%$. The lower concentrations of 0.5% and 0.1% had no effects on salivation even after 5-minute mouthwash. There was no significant difference between blood pressure and pulse rate before and after use of mouthwash. Conclusions: From the results of the current study, pilocarpine mouthwash with at least 1.0% concentration more than a minute might be clinically effective in salivation without any serious side effects. Dose of mouthwash rather than duration seems to be a critical factor to salivation.

• Journal of Oral Medicine and Pain
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• 제40권1호
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• pp.10-16
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• 2015

Purpose: Pilocarpine has the effects on improvement of salivary flow and subjective symptoms for xerostomic patients. Because of unwanted side effects following its systemic administration, topical pilocarpine has been paid attention as an alternative. This study aimed to investigate effects of pilocarpine solution as mouthwash on salivary flow and adverse effects compared to systemic administration of 5 mg pilocarpine tablet in healthy subjects. Methods: The study was a double blind, placebo-controlled, crossover clinical trial. Five milligrams pilocarpine tablets, 4 mL of 2% pilocarpine solution and placebo solution were given to 12 healthy volunteers (6 males and 6 females) in a predetermined order with wash-out period of at least two days and unstimulated whole saliva was collected before and after administration of each drug. Blood pressure and pulse rate was also measured and subjective effect and potential side effects were evaluated by a self-administrated questionnaire. Results: Systemic (5 mg tablet) and topical (2% solution) use of pilocarpine significantly increased salivary flow rate in healthy subjects compared to placebo (p<0.001). In both the pilocarpine solution and tablet groups, salivary flow rates at 120 minutes after administration remained increased. Subjective effect on salivation was the largest in the pilocarpine tablet group, followed by the pilocarpine solution group (p<0.05). There was no significant difference in blood pressure and pulse rate after administration of all three drugs. Fewer side effects reported in the pilocarpine solution group than in the tablet group. Conclusions: Two percents pilocarpine solution as mouthwash increases salivary flow rate, definitely superior to placebo solution and comparable to pilocarpine tablet, with fewer side effects in healthy subjects. It indicates a possibility of pilocarpine solution as a useful alternative of pilocarpine tablets for the xerostomic patients with systemic diseases.

• Journal of Oral Medicine and Pain
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• 제36권1호
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• pp.21-24
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• 2011

구강건조증이란 주관적인 구강 내 건조감으로 정의되며, 이는 약물, 타액선 질환, 방사선 치료, 쉐그렌 증후군, 심리적 요인 등과 같은 다양한 원인에서 비롯된다. 구강 건조증 환자 중 현저한 타액선 기능 감소가 존재하는 경우 구강캔디다증, 치아우식증, 치주질환, 미각변화, 구취 등의 병발증이 나타날 수 있다. 이러한 구강건조증의 치료로는 우선적으로 구강건조를 유발하는 원인요소를 제거하거나, 환자의 불편감을 감소시키기 위한 대증요법이 주가 되며 실제로 타액 분비 기능이 감소된 경우 이로 인한 합병증을 예방하기 위한 치료와 타액분비를 자극할 수 있는 약물치료를 시행할 수 있다. 이 중 타액분비를 촉진시키는 약물인 필로카핀은 구강건조증 치료제로 널리 사용되어 왔다. 하지만 발한작용, 비뇨기 및 위장관계의 비정상적인 기능유도, 심혈관계 및 호흡기계에 대한 위험 등의 부작용이 있어 천식, 만성폐질환, 심혈관계 질환자에게는 주의 깊은 사용이 요구되며, 특히 조절되지 않는 천식환자의 경우 필로카핀의 절대적 금기증으로 사용이 금지된다. 이처럼 구강건조증 치료에 있어 필로카핀은 부작용으로 인해 전신적인 투여에 많은 제한이 있다. 따라서, 필로카핀의 부작용을 최소화하기 위해 국소적으로 사용되는 방법 중의 하나인 필로카핀 양치액을 이용하여 치료한 증례를 통해 그 효과를 확인해보고자 하였다.