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Mrs. Pederson is a 74 year old who presents for a routine blood pressure follow up visit. Her blood pressure is well controlled, but on review of systems she reports dry mouth of several years duration that has acutely worsened over the past 2 months. She quit smoking after she developed thyroid cancer that required surgery and neck radiation for cure. She has been drinking more water than usual, but it only improves her symptoms for a few minutes. She drinks wine with dinner and sometimes before bed for insomnia. On physical examination this is the appearance of her tongue:
Joanna Douglass, BDS, DDS
All of the following are likely contributing to Mrs. Pederson’s xerostomia (the sensation of dry mouth) except:
Mrs. Pederson’s active medical problems include Hypertension, Type 2 Diabetes Mellitus, and Glaucoma. Her past history is remarkable for treated thyroid cancer, seasonal allergies, and intermittent insomnia. She smoked when she was younger, but quit 30 years ago. She is widowed and a retired administrative assistant. She enjoys a glass of wine about five times a week with dinner and walks daily for exercise.
Her medications include:
Based on the information provided above, which of the following scenarios would most likely contribute to Mrs. Pederson’s xerostomia?
Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and zolpidem. She understands the need for her antihypertensive and diabetic medications and will continue to take those as directed. After these changes her dry mouth improves to some degree, but is still symptomatic. She inquires what else she can do to improve her symptoms.
Which of the following interventions would be contraindicated for Mrs. Pederson?