DEAR DR. DONOHUE: I am a 75-year-old woman in very good health. My problem is a dry mouth. A doctor told me that it comes from medicines, but the only thing I take is a multivitamin. On waking in the morning, my tongue is pasted to the roof of the mouth and my teeth. My mouth gets so dry, it affects my speech. I have tried mouthwashes and sprays, but they last only a few minutes. Can you help me? – L.F.

ANSWER:
Everyone normally makes one to two quarts of saliva a day. Saliva has many functions. It lubricates the mouth, moistens food so it can be swallowed, maintains the proper balance of acids and bases in the mouth and inactivates harmful germs to prevent tooth decay. Saliva production has to decrease by 50 percent before a person senses the mouth has become dry.

Many medicines dry the mouth. Anticholinergics like Robinul, atropine and scopolamine (the patch used to prevent seasickness), Pamelor and other antidepressants, beta blockers, diuretics and calcium channel blockers are the chief offenders. You take none of these. Your multivitamin isn’t the cause.

A blockage of the salivary ducts dries the mouth. Diabetes and previous radiation to the face can diminish saliva production. If you sleep with your mouth wide open, you wake with a parched mouth. Sjogren’s (SHOW-grins) syndrome is notorious for producing a dry mouth. Dry eyes are often, but not always, part of that syndrome. Your doctor has to look for these causes. Without finding a cause, finding a cure will be elusive.

Keep with you at all times a water-filled, plastic squeeze bottle and don’t hesitate to use it frequently. Humidify your house, especially the bedroom. Become best friends with your dentist. Dry mouths promote cavities. Chew sugar-free gum.

Two medicines that promote saliva production are Evoxac and pilocarpine.

A number of artificial salivas and related products can keep the mouth moist for longer than a few minutes. OraMoist is a time-release disc that works well. So does Salivart spray. Biotene products are also effective. None of these requires a prescription. Numoisyn lozenges and liquid do require a prescription.

DEAR DR. DONOHUE: I passed through this winter without having the flu and without having had the flu shot. Something I saw in the paper prompted me to write to you. It said that flu medicines are no longer effective. Is that true? – B.R.

ANSWER:
The flu virus has developed a resistance to two formerly effective flu medicines, Symmetrel (amantadine) and Flumadine (rimantadine). That is true. This year has witnessed the flu virus’s less than great response to a third flu medicine, Tamiflu (oseltamivir). However, the virus is sensitive to the fourth flu medicine, Relenza (zanamivir), an inhaled medicine. It has been suggested that combining Tamiflu with Flumadine could be effective treatment against this virus.

DEAR DR. DONOHUE: When I was a youngster (I am in my 70s), I heard my parents and grandparents talk of people dying from consumption. Was there or is there such a disease? Would it be what we call cancer today? – C.D.

ANSWER:
“Consumption” is an old word for tuberculosis. Tuberculosis has been a major menace to humans almost from the beginning of time. Antibiotics have given us an upper hand with it, but in some people, the TB germ has learned how to resist the common TB medicines.

DEAR DR. DONOHUE: Will you discuss the best way to take multiple medicines in a 24-hour period? I have a friend who downs 13 pills at the same time. Does mixing numerous medicines change their effectiveness? – N.A.

ANSWER:
It’s hard not to imagine that, in a batch of 13 different medicines, one or two, at least, would be incompatible with the other 11 or 12. The incompatibility might be a lessened drug absorption in the digestive tract or it might be that some of those drugs react chemically with others in the blood. Your friend should get this straightened out with the doctor or with the pharmacist.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.


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