For use with external citation management software. Create file sorry, your browser is unsupported so ncbi web applications may not function properly. More information. Drug saf. generic viagra in us 2008;31(2):109-26. buy brand viagra canada Drug-induced hyperhidrosis and hypohidrosis: incidence, prevention and management. Cheshire wp, fealey rd. Source department of neurology, autonomic reflex laboratory, mayo clinic, 4500 san pablo road, jacksonville, fl 32224, usa. viagra generic Abstract the human sweating response is subject to the influence of diverse classes of drugs. Some act centrally at the hypothalamus or at spinal thermoregulatory centres, while others act at sympathetic ganglia or at the eccrine-neuroeffector junction. Pharmacological disturbances of sweating have broad clinical implications. viagra coupon Drugs that induce hyperhidrosis, or sweating in excess of that needed to maintain thermoregulation, can cause patient discomfort and embarrassment, and include cholinesterase inhibitors, selective serotonin reuptake inhibitors, opioids and tricyclic antidepressants. Drugs that induce hypohidrosis, or deficient sweating, can increase the risk of heat exhaustion or heat stroke and include antimuscarinic anticholinergic agents, carbonic anhydrase inhibitors and tricyclic antidepressants. As acetylcholine is the principal neuroeccrine mediator, anhidrosis is one of the clinical hallmarks by which acute anticholinergic toxicity may be recognized. buy generic viagra online The symptom of dry mouth often accompanies the less apparent symptom of hypohidrosis because the muscarinic m(3) acetylcholine receptor type predominates at both sweat and salivary glands. Management options include dose reduction, drug substitution or discontinuation. When compelling medical indications require continuation of a drug causing hyperhidrosis, the addition of a pharmacological agent to suppress sweating can help to reduce symptoms. can you buy viagra over counter brazil When hypohidrotic drugs must be continued, deficient sweating can be managed by avoiding situations of heat stress and cooling the skin with externally applied water. buy viagra cheap The availability of clinical tests for the assessment of sudomotor dysfunction in neurological disease has enhanced recognition of the complex effects of drugs on sweating. Advances in the understanding of drug-induced anhidrosis have also enlarged the therapeutic repertoire of effective treatments for hyperhidrosis. Pmid: 18217788 [pubmed - indexed for medline] publication types, mesh terms, substances publication types revi. instructions for taking viagra