INBDE Pharmacology Practice Test

Boosting acetylcholine at the salivary glands stimulates saliva production. Reversible acetylcholinesterase inhibitors block the breakdown of acetylcholine, so more of it remains at cholinergic synapses, including the muscarinic receptors on salivary gland cells. Activating these receptors drives increased secretory activity, which can relieve xerostomia. While classic sialogogues are direct muscarinic agonists, these inhibitors still raise salivation by enhancing parasympathetic signaling, making them a reasonable option for xerostomia under certain circumstances. Their broader cholinergic effects, though, can limit their use due to side effects like sweating, bradycardia, or bronchoconstriction. The other statements don’t fit because these agents do have clinical uses and do not cause xerostomia; their primary effect is to increase, not decrease, saliva flow.