A DOCS Education member asks:
What is the best anti-cholinergic to use to dry up saliva before starting a large restorative case? This mid-fifties male is healthy and takes no medication.
I would stay with hydroxyzine, up to 100mg. Some patients will have unwanted side effects with other anticholinergic medication (such as those used for motion sickness), which may include symptoms like blurred vision which would otherwise be concerning during a sedation appointment.
Hydroxyzine is a very safe medication when dispensed according to DOCS protocols. However, an overdose of a medication with anticholinergic effects can lead to anticholinergic syndrome, which poses a serious risk to patients. Should a patient self-medicate or neglect to include an anticholinergic on a health history, this mnemonic is used by doctors to identify the main symptoms:
- Blind as a bat (dilated pupils)
- Red as a beet (vasodilation/flushing)
- Hot as a hare (hyperthermia)
- Dry as a bone (dry skin)
- Mad as a hatter (hallucinations/agitation)
- Bloated as a toad (disruption in peristalsis)
- And the heart runs alone (tachycardia)
The information contained in this, or any case study post in Incisor should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 106 Lenora Street, Seattle, WA 98121. Please print a copy of this posting and include it with your question or request.