University of Texas School of Dentistry at Houston, Houston, TX, USA.
Am Fam Physician. 2020 Nov 15;102(10):613-621.
Drugs are being prescribed with more frequency and in higher quantities. A serious adverse drug event from prescribed medications constitutes 2.4% to 16.2% of all hospital admissions. Many of the adverse drug events present intraorally or periorally in isolation or as a clinical symptom of a systemic effect. Clinical recognition and treatment of adverse drug events are important to increase patient adherence, manage drug therapy, or detect early signs of potentially serious outcomes. Oral manifestations of commonly prescribed medications include gingival enlargement, oral hyperpigmentation, oral hypersensitivity reaction, medication-related osteonecrosis, xerostomia, and other oral or perioral conditions. To prevent dose-dependent adverse drug reactions, physicians should prescribe medications judiciously using the lowest effective dose with minimal duration. Alternatively, for oral hypersensitivity reactions that are not dose dependent, quick recognition of clinical symptoms associated with time-dependent drug onset can allow for immediate discontinuation of the medication without discontinuation of other medications. Physicians can manage oral adverse drug events in the office through oral hygiene instructions for gingival enlargement, medication discontinuation for oral pigmentation, and prescription of higher fluoride toothpastes for xerostomia.
药物的使用频率和剂量都在增加。处方药引起的严重药物不良反应占所有住院治疗的 2.4%至 16.2%。许多药物不良反应单独发生在口腔内或口周，或者作为全身效应的临床症状出现。临床识别和治疗药物不良反应对于提高患者的依从性、管理药物治疗或发现潜在严重后果的早期迹象非常重要。常用药物的口腔表现包括牙龈肿大、口腔色素沉着、口腔过敏反应、药物相关性骨坏死、口干和其他口腔或口周疾病。为了预防剂量依赖性药物不良反应，医生应谨慎地使用最低有效剂量和最短疗程来开处方。或者，对于非剂量依赖性的口腔过敏反应，快速识别与时间依赖性药物发作相关的临床症状可以允许立即停药，而无需停止其他药物。医生可以通过口腔卫生指导来管理口腔药物不良反应，如牙龈肿大、停止口腔色素沉着药物治疗、以及开处方使用含氟更高的牙膏来治疗口干。
