摘要:

SUMMARYNon‐steroidal anti‐inflammatory drugs (NSAIDs) are being prescribed increasingly with an H2‐antagonist. This article reviews those published studies which have examined the potential for pharmacokinetic and, where appropriate, pharmacodynamic interactions between these classes of drugs. Studies involving the administration of a single dose of a NSAID to young healthy volunteers are of limited relevance in establishing the likely effect of an H2‐antagonist on the blood concentrations of an NSAID in patients. Appropriate studies are those which will examine the effects of H2‐antagonists on the steady‐state pharmacokinetics of NSAIDs in patients with inflammatory joint diseases. More of such studies are required, particularly involving elder

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00676.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYThe activities of menthol and peppermint oil were determined in guinea‐pig ileal smooth muscle, in rat and guinea‐pig atrial and papillary muscle, in rat brain synaptosomes and in chick retinal neurones by pharmacological45Ca2+uptake and radioligand binding assays. Menthol is a major constituent of peppermint oil and is approximately twice as potent as peppermint oil as an inhibitor of K+depolarization‐induced and electrically stimulated responses in ileum and electrically stimulated atrial and papillary muscles. IC50values in the ileal preparation ranged from 7.7 to 28.1 μg ml−1and in the cardiac preparations from 10.1 to 68.5 μg ml−1. Similar potencies were demonstrated against K+depolarization‐induced45Ca2+uptake in synaptosomes and against K+depolarization and Bay K 8644‐induced uptake in chick retinal neurons. IC50values for menthol inhibition of K+and Bay K 8644 responses in the retinal neurons were 1.1 × 10−4M (17.2 μg ml−1) and 1.75 × 10−4M (26.6 μg ml−I), respectively, and for peppermint oil were 20.3 and 41.7 μg ml−1respectively. Both menthol and peppermint oil inhibited specific [3H]nitrendipine and [3H]PN 200–110 binding to smooth and cardiac muscle and neuronal preparations with potencies comparable to, but slightly lower than, those measured in the pharmacological and45Ca2+uptake experiments. Binding of menthol and peppermint oil, studied at 78 μg ml−1, was competitive against [3H]nitrendipine in both smooth muscle and synaptosome preparations. The data indicate that both menthol and peppermint oil exert Ca2+channel blocking properties which may underlie their use in irritable bowel syndrome. Ca2+channel antagonism may not be the only pharmacological effect of menthol and peppermint oil contributing to

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00677.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYThe aim of this study was to examine the serum concentrations of sex steroids and pituitary hormones in a randomly selected group of alcoholic cirrhotic men participating in a randomized, placebo‐controlled study on the efficacy of oral testosterone treatment on the liver. Before treatment, patients (n= 25) had median serum concentrations of testosterone, oestradiol, non‐protein bound oestradiol, non‐sex hormone binding globulin (SHBG) bound oestradiol and oestrone sulphate which did not differ significantly from those of healthy controls (n= 16), but the patients had significantly (P<0.01) higher median serum concentrations of oestrone, luteinizing hormone (LH), follicle‐stimulating hormone (FSH) and prolactin.The patients were randomized to treatment with either oral micronized testosterone (200 mg t.d.s.) or placebo for a median duration of 1 year. In the placebo group (n= 8), hormone concentrations at follow‐up were not significantly different from those at entry apart from a significant (P<0.05) increase in FSH concentrations. Median concentrations of testosterone, oestrone, and oestrone sulphate increased significantly (P<0.05) in the testosterone‐treated group (n= 17) when compared with concentrations at entry and concentrations in the placebo group. The testosterone‐treated group had significantly (P<0.05) higher serum concentrations of non‐protein bound and non‐SHBG bound oestradiol when compared with concentrations at entry, but no significant changes were observed regarding serum oestradiol and prolactin concentrations. Both LH and FSH concentrations decreased significantly (P<0.05) in the testosterone‐treated group when compared with concentrations at entry and concentrations i

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00678.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYIn an attempt to find the ideal analgesic to treat biliary tract pain we compared the effects of saline and equianalgesic doses of morphine, pentazocine, pethidine, and butorphanol on CCK—OP stimulated gallbladder emptying in healthy volunteers. Morphine produced a profound delay in gallbladder emptying while the other narcotics produced a significant delay in comparison to saline, but less than morphine. None of the drugs affected common bile duct diameter, bilirubin, liver enzymes or amylase. We recommend avoiding the use of morphine in the treatment of biliary and pancreatic pain, but although pethidine, pentazocine and butorphanol may be potentially detrimental we could find no definite superiority of one versus the other

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00679.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYWe investigated the effect of a slow‐release formula of trimoprostil, a prostaglandin E2analogue, at a dose of 3 mg b.d. on circadian intragastric acidity in nine healthy volunteers using ambulatory pH‐metry in a placebo‐controlled study. The effect of trimoprostil was long lasting (8 hours during the night). However, it lowered gastric pH on average only by 0.4 pH units. In four of the six women severe side‐effects occurred in the form of abdominal cramping, metrorrhagia, and/or diarrhoea. These disadvantages may limit the clinical use of th

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00680.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYBeta adrenoreceptor blocking drugs have been used for the prevention of haemorrhage from oesophageal varices. However, it is possible that these agents, by virtue of their effects on hepatic blood flow, may impair liver function and precipitate hepatic encephalopathy. We have therefore studied the effect of the beta blocking drug propranolol on hepatic encephalopathy in patients with cirrhosis and portal hypertension. Twenty patients were randomly assigned to receive 4 weeks treatment with propranolol or an identical‐looking placebo, the former given in a dose sufficient to reduce resting pulse rate by ≥ 25%. Before and after treatment patients were assessed for the severity of liver disease and the presence of encephalopathy. EEG mean cycle frequency and fasting arterial ammonia concentrations were also measured, and in order to detect latent hepatic encephalopathy, each patient underwent a battery of psychometric tests. Patients were blinded as to their treatment, as were those assessing their responses. Neither propranolol nor placebo had any significant effect on the parameters measured. On propranolol median EEG mean cycle frequency fell from 9.08 ct s−1(range 8.63–11.0 ct s−1) to 8.73 ct s−1(range 8.27–11.44 ct s−1), and median fasting arterial ammonia concentration fell from 66 μmol litre−1(range 40–329 μmol litre−1) to 49 μmol litre−1(range 37–188 μmol litre−1). Psychometric test values, while initially abnormal and suggestive of latent hepatic encephalopathy in the majority of patients, did not change

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00681.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYIn a randomized double‐blind trial 100 patients with severe bleeding peptic ulcers were treated with an intravenous (i.v.) infusion of cimetidine or somatostatin. Only those patients in whom endoscopy performed within 6 h of admission showed non‐arterial bleeding or signs of recent haemorrhage without a visible vessel entered the trial. The two treatment groups were well matched for age, sex, presence of underlying disease, prior ingestion of ulcerogenic drugs, tobacco habits, type of bleeding, haematocrit at admission, presence of hypovolaemic shock, source of bleeding and endoscopic findings. Four patients in each group were excluded after randomization. Further haemorrhage occurred in eight (17.3%) patients in the somatostatin group and in 10 (21.7%) in the cimetidine group, but the difference was not statistically significant. The number of surgical procedures, blood transfusion requirement, duration of hospitalization and mortality rates were similar in the two treatment groups. These results suggest that somatostatin does not improve the results obtained with cimetidine in patients with bleeding peptic ulcer, in whom the endoscopy discloses non‐arterial bleeding or signs of recent haemorrhage without a visible v

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00682.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYThe effects on gastric acid secretion and serum gastrin of 4 weeks treatment with famotidine 40 mg nocte or cimetidine 800 mg nocte (at 2200 h) were studied in 16 patients with previous duodenal ulcer. Patients were studied before commencing therapy, on days 5, 12 and 26 of treatment, and on days 3, 10 and 24 after completion of therapy. In contrast to cimetidine, basal and pentagastrin‐stimulated gastric acid secretion measured 12 h after dosing was significantly inhibited during treatment with famotidine. In addition, with famotidine there was inhibition of stimulated gastric acid secretion at 3 and 24 days after completion of treatment. Fasting serum gastrin measured 12 h after dosing was not significantly altered by either dru

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00683.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYTherapy for diarrhoea associated with the carcinoid syndrome is often unsatisfactory. In an open study ICS 205‐930 (Sandoz Limited), a novel 5HT3‐antagonist, controlled diarrhoea in five of six patients studied. This drug may be a useful advance in the symptomatic treatment of the carcinoid syndr

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00684.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYThe effect of cigarette smoking and its active component, nicotine, on the gastric emptying of solid food was assessed in a randomized double‐blind crossover design. Ten regular smokers were studied after a 6 h fast and least 18 h after their last cigarette. Subjects smoked a total of three high (1.91 mg) or low (0.17 mg) nicotine cigarettes, before and after a technetium‐labelled solid meal and were scanned by gamma camera periodically over a 2‐h period. All calculations of gastric emptying revealed a significant delay after smoking highversuslow nicotine cigarettes in: mean per cent isotope remaining in the stomach at each measurement point from 90–120 min; amount of meal remaining in the stomach at 2 h; and mean time at which 50% of the meal had emptied (T1/2). Delay in gastric emptying was significantly correlated with increase in serum nicotine concentration on the high nicot

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00685.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY