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Learning Objectives

1 Explain to the patient the symptons of Sjögren's syndrome and make a distinction between primary and secondary Sjögren's syndrome.
2 Distinguish between dry mouth that is related to true secretory hypofunction and one that may be psychogenic.
3 Explain the autoimmune response system that causes Sjögren's syndrome and the role played by hereditary and environmental factors.
4 Identify and diagnose other causes of dry eyes and dry mouth.
5 Outline the therapeutical treatment approach for Sjögren's syndrome that is directed at improving symptoms, preventing the complications and retarding the disease progression.
6 List the salivary and nonsalivary courses of complaints of xerostomia.
7 Demonstrate Schimer Tear test to determine the eye dryness.
8 Describe the treatment of dry eyes in Sjögren's syndrome patients.
9 List the choice of artificial tears commercially available and point out seven considerations that the patient and the physician must take into account in their selection and usage.
10 Discuss the advantages and side effects caused by certain medications used by Sjögren's syndrome patient to alleviate dry mouth or oral mucositis, such as Benadryl, steroids, tetracycline and mouthrinses.
11 Provide treatment alternatives to oral Candida mucositis, oral dryness and tooth decay in Sjögren's patients.
12 Provide a treatment protocol for nasal dryness, sinusitis and upper airway dryness in patients with Sjögren's syndrome.
13 Discuss gynecologic issues - vaginal dryness, estrogen replacement therapy, risks of pregnancy-with patients who have Sjögren's syndrome.
14 Distinguish between two types of fatigue in patients with Sjögren's syndrome: inflammatory fatigue and morning fatigue.
15 Evaluate the symptoms and causes of fatigue and sleep disturbances in patients with Sjögren's syndrome and suggest behavioral modifications and pharmaceutical interventions.
16 Analyze depression in Sjögren's syndrome patients and indicate antidepressant drugs that may provide relief.
17 Discuss heartburn and esophageal motility in Sjögren's syndrome and suggest a few relief measures.
18 Discuss the results of clinical trials testing pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjögren's syndrome.
19 List some of the adverse experiences occurring with pilocarpine tablets.