RESUMEN
The quarternary ammonium antimuscarinic drugs propantheline bromide and clidinium bromide, given orally at the usual therapeutic doses, delayed gastric emptying of a swallowed radiolabeled liquid meal as measured by a gamma camera. Delay of emptying was dose dependent. If an identical meal was given by gastric tube, there was no slowing of emptying by propantheline in the group as a whole. Six subjects who emptied the intubated meal more quickly with placebo had slowed emptying after 30 mg propantheline. In five others, intubation alone slowed gastric emptying while the addition of 30 mg propantheline caused a paradoxical acceleration of gastric emptying. Clidinium bromide, 5 mg, delayed gastric emptying to the same extent as 15 mg propantheline bromide without the marked suppression of salivary secretion induced by the latter.
Asunto(s)
Vaciamiento Gástrico/efectos de los fármacos , Propantelina/farmacología , Quinuclidinas/farmacología , Administración Oral , Adulto , Femenino , Humanos , Masculino , Propantelina/administración & dosificación , Quinuclidinas/administración & dosificación , Factores de TiempoRESUMEN
The present study shows that a single oral recommended dose of propantheline bromide normally doubles the mean gastric half-emptying time in man. In a prospective, double-blind, randomized crossover design 13 normal subjects were given 30 mg propantheline or placebo 90 min before taking a 113m-indium-labeled liquid test meal, the volume of which was adjusted to body weight. The disappearance of radioisotope from the area of the stomach was determined by external gamma counting. After placebo the mean half-emptying time was 68 min and after propantheline it was 135 min (p less than 0.005). Although salivary flow decreased and pulse rate increased there were no visual disturbances. In studies already reported maximally tolerated oral doses of quaternary ammonium anticholinergic drugs have not consistently retarded gastric emptying in man.
Asunto(s)
Motilidad Gastrointestinal/efectos de los fármacos , Propantelina/farmacología , Estómago/efectos de los fármacos , Adulto , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Alimentos , Humanos , Masculino , Propantelina/efectos adversos , Pulso Arterial/efectos de los fármacos , Salivación/efectos de los fármacos , Estómago/fisiología , Factores de TiempoRESUMEN
Aluminum hydroxide gel delays gastric emptying in rats and man. This effect of aluminum hydroxide gel varies with the concentration of aluminum in solution in the stomach when pH, osmolarity, and anion content are held constant. Because aluminum solubility drops as pH is raised, those antacids which neutralize more effectively than aluminum hydroxide gel alone and which contain "nonreactive" aluminum hydroxide result in lower aluminum concentration and do not affect the rate of gastric emptying in animals or in man. By using [51Cr]sodium chromate and a gamma camera technique, half-emptying time in 6 subjects with no gastrointestinal disease was shown to be prolonged from 13.1 min after water ingestion to 48.0 min after three hourly doses of aluminum hydroxide gel. Conventional nonabsorbable markers, including phenol red, were found to be of limited use for studying gastrointestinal function in the presence of antacid gels, most of which adsorb dyes.