Medications That Can Exacerbate Sjogren’s Syndrome: Prevention And Treatment

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Medications That Can Exacerbate Sjogren’s Syndrome: Prevention And Treatment

Sjogren’s Syndrome is a chronic autoimmune disorder characterized by dry eyes and dry mouth.
Pharmacists play a crucial role in managing this disease by identifying medications that can exacerbate the
symptoms and ensuring appropriate treatment. In this article, we will discuss the medications that can
worsen Sjogren’s Syndrome and the medications used to manage it.
Anticholinergic Medications And Sjogren’s Syndrome Prevention
Anticholinergic medications block the action of acetylcholine, a neurotransmitter that plays a crucial role in
the functioning of the parasympathetic nervous system. This system is responsible for regulating bodily
functions, including tear and saliva production. Anticholinergic medications can exacerbate the dry eyes
and dry mouth symptoms of Sjogren’s Syndrome. Therefore, pharmacists should pay close attention to the
medication list of patients with this diagnosis and avoid prescribing drugs with high anticholinergic activity.

Commonly used oral medications with a high degree of anticholinergic activity include tricyclic
antidepressants, first-generation antihistamines, anti-Parkinson’s agents, urinary anticholinergics, and
some antipsychotics. Inhaled anticholinergics, such as ipratropium, aclidinium, glycopyrronium, tiotropium,
umeclidinium, and revefenacin, can also contribute to dry mouth.
Sjogren’s Syndrome Treatment: Medications To Manage Symptoms
In addition to avoiding medications that can exacerbate Sjogren’s Syndrome symptoms, pharmacists should
be aware of medications used to manage the disease. Two medications commonly used to treat dry eyes
and dry mouth in Sjogren’s Syndrome patients are Restasis and pilocarpine.
Restasis is an ophthalmic emulsion used to increase tear production in patients with chronic dry eyes.
Pharmacists should be cautious when prescribing Restasis to Sjogren’s Syndrome patients as it can worsen
dry mouth symptoms.
Pilocarpine is a cholinergic agonist that stimulates saliva production and can improve dry mouth symptoms.
However, it can cause side effects such as sweating, nausea, and increased urinary frequency. Pilocarpine
should be used with caution in patients with cardiovascular disease and asthma.
In addition to paying close attention to medications that can exacerbate Sjogren’s Syndrome, it’s also
important for pharmacists to educate patients about the potential side effects of their medications.
Patients with Sjogren’s Syndrome may not be aware of the anticholinergic effects of their medications or
how they can worsen their dry eye and dry mouth symptoms. Pharmacists can help by explaining the
potential risks and benefits of their medications and working with the prescriber to find alternative
treatments if necessary. By taking a proactive approach to Sjogren’s Syndrome prevention and treatment,
pharmacists can play a vital role in improving the quality of life for patients with this chronic autoimmune
disease.