摘要:

SUMMARYExperience obtained during post‐marketing surveillance of the safety of cimetidine emphasizes the difficulties in interpretation posed by the high background frequency of disease of all types in drug takers. The multiple sources of confounding factors, and their high prevalence, make it impossible to detect adverse events which mimic ordinary disease, particularly when a consistent relationship between adverse event and drug exposure is not observed. The inclusion of controls emphasizes the difficulties but does not ease interpretatio

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00616.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThe synthetic opioid, loperamide, reduces stool weight, frequency of bowel movements, urgency and faecal incontinence in acute and chronic diarrhoea. In man, the mechanism of action of loperamide is primarily the retardation of small‐intestinal transit, and the stimulation of anal sphincter pressure and of faecal continence. This mechanism increases mucosal contact time, allowing more complete absorption of electrolytes and water. Studies in animals have demonstrated inhibitory effects of opiates and opioids, including loperamide, on fluid and electrolyte secretion induced by various secretagogues. By comparison, opiates have smaller if any antisecretory or pro‐absorptive actions in man. The discrepancies between the results obtained in animal and human experiments are most certainly due to the large differences between drug doses used. Besides its opiate‐receptor binding and stimulating activity, loperamide also behaves as a calcium–calmodulin antagonist and as a calcium channel blocker. These two other mechanisms might contribute to loperamide's antidiarrhoeal activity. Loperamide is more effective and safer than other opiates or opioid drugs in the treatment of both infantile and adult diarrhoea of various causes, although adequate fluid and electrolyte replacement remain the pri

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00617.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYThis article reviews the chemistry, actions and chemical applications of somatostatin and its analogues. At present, their gastroenterological use should be considered in patients with the carcinoid syndrome and functioning pancreatic endocrine tumours; in endocrinology there is interest in their use for the management of patients with resistant acromegaly. With these possible exceptions, somatostatin analogues should at present be used only in the context of clinical trials.

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00618.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYWe report a patient who developed sulphasalazine‐related hepatitis with a subsequent adverse reaction to rectal 5‐amino salicylic acid, in the form of pain and fever without associated liver dysfunction, suggesting reactions to both components of sulphasalazine. Included is a review of the literature. Caution should be observed when prescribing 5‐amino salicylic acid to sulphasalazine‐intolerant p

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00619.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYGastrointestinal transit of an enteric‐coated, delayed‐release 5‐aminosalicylic acid tablet radiolabelled with indium‐111 has been monitored in a preliminary study with eight healthy subjects using gamma scintigraphy. Gastric emptying of the tablet was delayed by the presence of food in the stomach. Disintegration occurred about 5 hours after the tablet left the stomach. There was close agreement between the tablet disintegration times and the initial detection of drug in the blood. The site of disintegration could be established in most instances; approximately 80% of the doses resulted in drug dispersion within the ascending colon. The coated tablets provide an effective means of drug delivery to the proxima

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00620.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYContinuous measurement of 24‐hour intragastric acidity was performed in 12 duodenal ulcer patients in remission during treatment with placebo, ranitidine 300 mg nocte and ranitidine 300 mg b.d. Median 24‐hour acidity was 79.4 mmol litre−1during placebo treatment; it decreased to 28.2 mmol litre−1during treatment with ranitidine 300 mg nocte and to 3.6 mmol litre−1during treatment with ranitidine 300 mg b.d. The two regimens decreased intragastric acidity to a similar degree during the night, but significantly greater inhibition of daytime and 24‐hour acidity followed use of ranitidine

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00621.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYTwenty‐four‐hour intragastric acidity and plasma gastrin concentration were measured in healthy subjects (n= 16), and patients with duodenal (n= 12) or gastric (n= 10) ulceration, or pernicious anaemia (n= 8). Median integrated 24‐hour intragastric acidity was highest in duodenal ulcer patients and lowest in pernicious anaemia patients (1148 and 0 mmol. hour litre−1, respectively). Median integrated 24‐hour plasma gastrin was highest in pernicious anaemia and lowest in the healthy subjects (9886 and 238 pmol. hour litre−1, respectively). Pernicious anaemia patients have unremitting hypergastrinaemia throughout the 24 hours. The results of this study not only provide a reference range of acidity and plasma gastrin in health and disease, but also will act as a baseline for future studies using antisecr

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00622.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYSimultaneous 24‐hour intragastric acidity and plasma gastrin concentrations were measured in 12 duodenal ulcer patients before and on the twenty‐eighth day of treatment with either ranitidine 150 mg b.d. or omeprazole 20 mg o.m. Median integrated 24‐hour intragastric acidity was decreased significantly from 1148 to 490 and 36 mmol. hour litre−1during treatment with ranitidine and omeprazole, respectively, whilst median intragastric 24‐hour plasma gastrin was raised significantly from 328 to 799 and 1519 pmol. hour litre−1respectively. When the results of all 48 experiments were considered together, there was a significant inverse correlation between the 24‐hour integrated values for intragastric acidity and plasma gastrin concentration. Both drugs caused a significant elevation of plasma gastrin throughout the 24 hours, although ranitidine had no effect on intragastric acidity from 1900 to 2200 hours. When compared with similar profiles of acidity and gastrin in pernicious‐anaemia patients, the modest elevations of plasma gastrin observed in this study suggest that neither drug will be associated with clinically relevant enterochromaffin‐like cell proliferation in duoden

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00623.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

SUMMARYBetween‐day pentagastrin testing yields highly reproducible stimulated gastric acid output values, but little is known of the reproducibility of repeated within‐day pentagastrin tests. We have performed three pentagastrin tests within the 1 day in nine healthy subjects. Within‐day tests were 6 hours apart; the first followed an overnight fast and the second and third were both 4 hours after a substantial meal. A further test was performed the following morning, again after an overnight fast, which allowed comparison of within‐day and between‐day testing. In the second and third within‐day tests there was a marked decrease of stimulated gastric acid output, with both maximal and peak acid output decreased to approximately half of the value of the first test (P<0.01). By contrast there were no significant differences in the acid output values obtained in between‐day tests (both following an overnight fast). Possible mechanisms for the decreased output on repeated within‐day testing include alterations in the sensitivity of the gastrin receptor, or some neurohumoral influence secondary to the preceding meal. Future studies of the duration of action of drugs affecting acid secretion may need to take account of

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1987.tb00624.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY