RESUMEN
Antipsychotic-induced sialorrhea carries a significant burden, but evidence-based treatment guidance is incomplete, warranting network meta-analysis (NMA) of pharmacological interventions for antipsychotic-related sialorrhea. PubMed Central/PsycInfo/Cochrane Central database/Clinicaltrials.gov/WHO-ICTRP and the Chinese Electronic Journal Database (Qikan.cqvip.com) were searched for published/unpublished RCTs of antipsychotic-induced sialorrhea (any definition) in adults, up to 06/12/2023. We assessed global/local inconsistencies, publication bias, risk of bias (RoB2), and confidence in the evidence, conducting subgroup/sensitivity analyses. Co-primary efficacy outcomes were changes in saliva production (standardized mean difference/SMD) and study-defined response (risk ratios/RRs). The acceptability outcome was all-cause discontinuation (RR). Primary nodes were molecules; the mechanism of action (MoA) was secondary. Thirty-four RCTs entered a systematic review, 33 NMA (n = 1958). All interventions were for clozapine-induced sialorrhea in subjects with mental disorders. Regarding individual agents and response, metoclopramide (RR = 3.11, 95% C.I. = 1.39-6.98), cyproheptadine, (RR = 2.76, 95% C.I. = 2.00-3.82), sulpiride (RR = 2.49, 95% C.I. = 1.65-3.77), propantheline (RR = 2.39, 95% C.I. = 1.97-2.90), diphenhydramine (RR = 2.32, 95% C.I. = 1.88-2.86), benzhexol (RR = 2.32, 95% C.I. = 1.59-3.38), doxepin (RR = 2.30, 95% C.I. = 1.85-2.88), amisulpride (RR = 2.23, 95% C.I. = 1.30-3.81), chlorpheniramine (RR = 2.20, 95% C.I. = 1.67-2.89), amitriptyline (RR = 2.09, 95% C.I. = 1.34-3.26), atropine, (RR = 2.03, 95% C.I. = 1.22-3.38), and astemizole, (RR = 1.70, 95% C.I. = 1.28-2.26) outperformed placebo, but not glycopyrrolate or ipratropium. Across secondary nodes (k = 28, n = 1821), antimuscarinics (RR = 2.26, 95% C.I. = 1.91-2.68), benzamides (RR = 2.23, 95% C.I. = 1.75-3.10), TCAs (RR = 2.23, 95% C.I. = 1.83-2.72), and antihistamines (RR = 2.18, 95% C.I. = 1.83-2.59) outperformed placebo. In head-to-head comparisons, astemizole and ipratropium were outperformed by several interventions. All secondary nodes, except benzamides, outperformed the placebo on the continuous efficacy outcome. For nocturnal sialorrhea, neither benzamides nor atropine outperformed the placebo. Active interventions did not differ significantly from placebo regarding constipation or sleepiness/drowsiness. Low-confidence findings prompt caution in the interpretation of the results. Considering primary nodes' co-primary efficacy outcomes and head-to-head comparisons, efficacy for sialorrhea is most consistent for the following agents, decreasing from metoclopramide through cyproheptadine, sulpiride, propantheline, diphenhydramine, benzhexol, doxepin, amisulpride, chlorpheniramine, to amitriptyline, and atropine (the latter not for nocturnal sialorrhea). Shared decision-making with the patient should guide treatment decisions regarding clozapine-related sialorrhea.
Asunto(s)
Antipsicóticos , Clozapina , Sialorrea , Adulto , Humanos , Antipsicóticos/efectos adversos , Clozapina/uso terapéutico , Sulpirida/efectos adversos , Amisulprida/efectos adversos , Sialorrea/inducido químicamente , Sialorrea/tratamiento farmacológico , Doxepina/efectos adversos , Amitriptilina/efectos adversos , Metaanálisis en Red , Propantelina/efectos adversos , Trihexifenidilo/efectos adversos , Metoclopramida/efectos adversos , Clorfeniramina/efectos adversos , Astemizol/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Ciproheptadina/efectos adversos , Difenhidramina/efectos adversos , Ipratropio/efectos adversos , Derivados de Atropina/efectos adversosAsunto(s)
Digoxina/farmacología , Imidazoles/farmacología , Propantelina/farmacología , Digoxina/efectos adversos , Digoxina/uso terapéutico , Combinación de Medicamentos , Interacciones Farmacológicas/fisiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Femenino , Insuficiencia Cardíaca/tratamiento farmacológico , Humanos , Imidazoles/efectos adversos , Masculino , Propantelina/efectos adversosRESUMEN
The pharmacological response with tilt-table testing predicts long-term efficacy in neurocardiogenic syncope. However, beta-blockers for neurocardiogenic syncope are often not tolerated or are ineffective. Since cholinergic tone is important in the efferent part of the neurocardiogenic reflex, we investigated the pharmacodynamics and efficacy of propantheline bromide in preventing neurocardiogenic syncope. We studied 16 patients (11 males) with a mean age of 48.8 (+/- 15.1) years with presyncope or syncope and who had positive baseline tilt-table studies at a mean of 15.8 (+/- 10.3) minutes into the upright 60 degrees tilt. They were given propantheline bromide orally, an anticholinergic agent, at a dose of 64.3 (+/- 21.8) mg/day for 7 days, and tilt-table testing was repeated 1 hour after readministration of propantheline bromide, 30 mg orally. After propantheline bromide treatment, 13 of 16 patients (81%) had no inducible presyncope or syncope on repeat tilt-table testing. In this group of responders, the mean minimum heart rate during upright tilt-table testing increased from 43.2 (+/- 77.3) beats/min to 77.3 (+/- 17.2) beats/min after propantheline bromide (p < 0.005). More significantly, the minimum mean arterial blood pressure increased from 42.2 (+/- 25) mmHg to 81.3 (+/- 16.7) mmHg (p < 0.0005) during upright tilt. At a follow-up of 15.2 (+/- 7.4) months, in the responder group (12 patients with long-term follow-up), the average dose of propantheline bromide was 32.5 (+/- 23.8) mg/day, which was significantly reduced from the initial dose (p < 0.05). A clinical recurrence of symptoms occurred in only 4 out of 12 patients on propantheline bromide (33%), none of which were directly attributable to drug failure. It was concluded from this study that propantheline bromide is highly effective in preventing neurocardiogenic syncope. In addition, propantheline bromide's effectiveness is more than would be expected by prevention of cardioinhibition in neurocardiogenic syncope and would support a role for direct cholinergic control of vascular tone.
Asunto(s)
Antagonistas Colinérgicos/uso terapéutico , Parasimpatolíticos/uso terapéutico , Propantelina/uso terapéutico , Síncope Vasovagal/tratamiento farmacológico , Pruebas de Mesa Inclinada , Adolescente , Adulto , Anciano , Antagonistas Colinérgicos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Parasimpatolíticos/efectos adversos , Cooperación del Paciente , Pronóstico , Propantelina/efectos adversos , Estudios Prospectivos , Recurrencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To compare the efficacy of penthienate with that of propantheline and placebo for treatment of primary idiopathic detrusor instability. DESIGN: Two prospective, randomised, crossover trials (double-blind for penthienate versus placebo and non-blinded for penthienate versus propantheline). SETTING: Urology Clinic of Prince Henry Hospital, Sydney, NSW (an outpatient clinic of a tertiary referral hospital), in 1993-1994. PARTICIPANTS: Neurologically intact patients with urodynamically proven detrusor instability, urgency and urge incontinence, but no stress incontinence (20 participated in the penthienate/placebo trial and 23 in the penthienate/propanthelin trial). OUTCOME MEASURES: Cystometrography results before and after treatment; frequency and volumes of urine voided in weeks 1 and 4 of treatment; and patient scores for degree of continence, side effects, efficacy and acceptability of treatment. INTERVENTIONS: Penthienate (5 mg), propantheline (15 mg) or placebo (all three times a day) for 4 weeks. RESULTS: Penthienate produced significantly greater improvements than placebo in frequency (daytime, P = 0.002; and night-time, P = 0.02), incontinence scores (P = 0.002) and amplitude of unstable detrusor contractions, when present (P = 0.01), and significantly increased diurnal and nocturnal bladder capacity, both on cystometrography (P = 0.003) and by voiding-diary records (P < 0.001). It also increased residual urine volume over the baseline level, but not significantly. Side effects, especially dry mouth, were common with penthienate, and one patient developed urinary retention. Penthienate was significantly better than propantheline in improving cystometric capacity (P = 0.03), and reducing the amplitude of unstable detrusor contractions (P = 0.01), and was perceived as more effective by patients for frequency, nocturia and incontinence. CONCLUSIONS: Penthienate (5 mg three times a day) was objectively and subjectively significantly better than both placebo and propantheline (15 mg three times a day) for treatment of primary idiopathic detrusor instability.
Asunto(s)
Parasimpatolíticos/uso terapéutico , Propantelina/uso terapéutico , Compuestos de Amonio Cuaternario/uso terapéutico , Incontinencia Urinaria/tratamiento farmacológico , Incontinencia Urinaria/etiología , Adulto , Anciano , Estudios Cruzados , Método Doble Ciego , Humanos , Persona de Mediana Edad , Parasimpatolíticos/efectos adversos , Propantelina/efectos adversos , Estudios Prospectivos , Compuestos de Amonio Cuaternario/administración & dosificación , Resultado del Tratamiento , Incontinencia Urinaria/fisiopatología , Urodinámica/efectos de los fármacosRESUMEN
Clinical efficacy and adverse effects of oxybutynin and propantheline in the treatment of symptoms related to detrusor hyperactivity were studied in a randomized, controlled, double-blind multicenter trial. Of 169 patients entered into the study 154 were evaluable for statistical analysis. Mean grade of improvement (visual analogue scale) was significantly higher with oxybutynin (58.2%) versus propantheline (44.7%) and placebo (43.4%). Mean bladder volume at first involuntary cystometric contraction was significantly increased with oxybutynin (+57.0 ml.) versus placebo (-9.7 ml.). Mean maximum cystometric bladder capacity was also significantly increased with oxybutynin (+80.1 ml.) versus placebo (+22.5 ml.). Rate of inquired possible adverse effects was significantly higher for oxybutynin (63%) versus propantheline (44%) and placebo (33%). However, only 5 patients dropped out of the study because of adverse effects (oxybutynin 2 and propantheline 3). No serious or lasting adverse effects were encountered with dryness of the mouth being the major complaint. Oxybutynin has statistically significant effects on subjective symptoms and objective urodynamic parameters in patients with detrusor hyperactivity compared to propantheline.
Asunto(s)
Ácidos Mandélicos/uso terapéutico , Parasimpatolíticos/uso terapéutico , Propantelina/uso terapéutico , Trastornos Urinarios/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Método Doble Ciego , Femenino , Humanos , Masculino , Ácidos Mandélicos/efectos adversos , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Parasimpatolíticos/efectos adversos , Propantelina/efectos adversos , Vejiga Urinaria/efectos de los fármacos , Vejiga Urinaria/fisiopatología , Trastornos Urinarios/fisiopatologíaRESUMEN
Using computerized pharmacy records from 1969 to 1973 for a cohort of 143,574 members of the Kaiser Permanente Medical Care Program, we have been testing associations of 215 drugs or drug groups with subsequent incidence of cancer at 56 sites. This paper presents findings with follow-up through 1984. There were 227 statistically significant (P less than 0.05, two-tailed) associations: 170 positive, 57 negative. Some were undoubtedly chance findings; others were likely due to confounding by unmeasured covariables. However, several associations suggested hypotheses for further studies and/or the need for continued observation. Most notable among findings not previously reported were associations of several antibiotics, both oral and topical, with lung cancer. These associations could not be explained by indications for drug use or by differences in smoking habits between users and nonusers, and suggest a possible link between the occurrence of bacterial infections and risk for cancer. In general, our results continue to suggest that most medications used during that period did not affect cancer incidence substantially. However, for less frequently prescribed medications, our power to detect moderate increases in cancer risk was quite low.
Asunto(s)
Carcinógenos/análisis , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Neoplasias/inducido químicamente , Antibacterianos/efectos adversos , Atropa belladonna , Eritromicina/efectos adversos , Neoplasias Esofágicas/inducido químicamente , Ácido Fólico/efectos adversos , Estudios de Seguimiento , Neoplasias Gastrointestinales/inducido químicamente , Neoplasias Pulmonares/inducido químicamente , Linfoma no Hodgkin/inducido químicamente , Mieloma Múltiple/inducido químicamente , Neomicina/efectos adversos , Neoplasias/epidemiología , Fenilbutazona/efectos adversos , Piperidonas/efectos adversos , Plantas Medicinales , Plantas Tóxicas , Polimixina B/efectos adversos , Propantelina/efectos adversos , Secobarbital/efectos adversos , Sulfatiazoles/efectos adversos , Vitaminas/efectos adversosRESUMEN
Two of the principal drugs used to treat detrusor instability, oxybutinin hydrochloride and propantheline bromide, were compared using clinical and urodynamic outcome measures in a randomized crossover trial with a patient-regulated variable dose regimen. Of the 23 women in the trial, 14 reported subjective improvement during treatment with oxybutinin hydrochloride compared with 11 during treatment with propantheline bromide. Apart from a greater increase in the maximum cystometric capacity with oxybutinin, there were no other objective differences between the two drugs. Oxybutinin significantly delayed the first desire to void, increased the maximum cystometric capacity and reduced the maximum detrusor pressure rise on filling. Propantheline significantly increased the maximum cystometric capacity and reduced the maximum detrusor pressure rise on filling. Three patients stopped treatment due to side-effects.
Asunto(s)
Ácidos Mandélicos/uso terapéutico , Parasimpatolíticos/uso terapéutico , Propantelina/uso terapéutico , Enfermedades de la Vejiga Urinaria/tratamiento farmacológico , Trastornos Urinarios/tratamiento farmacológico , Adulto , Anciano , Ensayos Clínicos como Asunto , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Ácidos Mandélicos/efectos adversos , Persona de Mediana Edad , Parasimpatolíticos/efectos adversos , Propantelina/efectos adversos , Distribución Aleatoria , Enfermedades de la Vejiga Urinaria/complicaciones , Enfermedades de la Vejiga Urinaria/fisiopatología , Trastornos Urinarios/etiología , Trastornos Urinarios/fisiopatología , UrodinámicaRESUMEN
Effects of orally-administered pirenzepine and propantheline bromide on food-stimulated gastric acid secretion, serum gastrin concentration, salivary flow and heart rate were compared in 10 duodenal ulcer patients in a placebo-controlled, double-blind study. Pirenzepine inhibited acid secretion by 25, 36 and 44% at doses of 50, 100, and 150 mg, respectively, while propantheline inhibited acid secretion by 32 and 41% at doses of 15 and 45 mg, respectively. None of the doses of pirenzepine affected food-stimulated serum gastrin concentrations, whereas 45 mg propantheline increased serum gastrin concentration significantly above placebo control. Enhancement of gastrin release by propantheline was not due to its antisecretory effect since intragastric pH after the meal was held constant at 5.0 by intragastric titration in vivo. Pirenzepine had no significant effect on heart rate and little or no inhibitory effect on salivary volume, depending on the dose administered. By contrast, both doses of propantheline increased heart rate and reduced salivary volume significantly (P less than 0.05). Thus, pirenzepine and propantheline in the doses administered inhibited acid secretion to approximately the same extent but pirenzepine had fewer effects on other organs.
Asunto(s)
Úlcera Duodenal/fisiopatología , Ácido Gástrico/metabolismo , Gastrinas/sangre , Frecuencia Cardíaca/efectos de los fármacos , Pirenzepina/farmacología , Propantelina/farmacología , Salivación/efectos de los fármacos , Adulto , Método Doble Ciego , Femenino , Alimentos , Humanos , Masculino , Persona de Mediana Edad , Pirenzepina/efectos adversos , Propantelina/efectos adversosAsunto(s)
Ansiolíticos/uso terapéutico , Bromazepam/uso terapéutico , Enfermedades Funcionales del Colon/tratamiento farmacológico , Propantelina/uso terapéutico , Adolescente , Adulto , Anciano , Bromazepam/efectos adversos , Ensayos Clínicos como Asunto , Enfermedades Funcionales del Colon/psicología , Quimioterapia Combinada , Femenino , Humanos , Masculino , Escala de Ansiedad Manifiesta , Persona de Mediana Edad , Propantelina/efectos adversosRESUMEN
Pirenzepine is an antisecretory anticholinergic type drug that has recently been shown to be relatively free of usual anticholinergic side effects on esophageal smooth muscle. It has also been suggested that this drug might release some of the inhibitory control of the esophagus and allow increased muscle contractions. To test this hypothesis, we compared the response of the lower esophageal sphincter (LES) and esophageal peristaltic contractions to bethanechol in 12 healthy controls after background oral doses of placebo, pirenzepine (50 mg), and propantheline (30 mg). After baseline placebo, bethanechol (40 micrograms/kg subcutaneously) produced the expected significant increases in LES pressure and amplitude of peristaltic contractions. Maximal increases were 51.9 +/- 14.9 and 29.5 +/- 7.0%, respectively. Also as expected, propantheline inhibited the cholinergic stimulation from bethanechol, allowing only a 10.1 +/- 13.6% increase in LES pressure and a decrease in peristaltic contraction amplitudes (-44.1 +/- 5.0%) after bethanechol. After background pirenzepine, the responses to bethanechol were intermediate between the other two drugs. A significant increase (44.2 +/- 16.4%) in LES pressure occurred after bethanechol while no significant changes (6.9 +/- 5.8%) were noted in peristaltic amplitudes with this drug. Typical side effects of dry mouth were noted in six of the 12 subjects with propantheline and in only three subjects after pirenzepine. These studies once again confirm the absence of usual anticholinergic side effects with oral pirenzepine compared to oral propantheline in the doses studied. We could find no evidence for a release of cholinergic inhibition after pirenzepine administration.
Asunto(s)
Benzodiazepinonas/farmacología , Esófago/efectos de los fármacos , Fármacos Gastrointestinales/farmacología , Contracción Muscular/efectos de los fármacos , Propantelina/farmacología , Adulto , Benzodiazepinonas/efectos adversos , Betanecol , Compuestos de Betanecol/antagonistas & inhibidores , Compuestos de Betanecol/farmacología , Esófago/fisiología , Femenino , Fármacos Gastrointestinales/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Pirenzepina , Presión , Propantelina/efectos adversos , Distribución Aleatoria , Receptores Muscarínicos/efectos de los fármacos , Xerostomía/inducido químicamenteRESUMEN
Hyperreflexia is the most common urological finding in patients with multiple sclerosis. A prospective randomized study was done to compare the effectiveness of 2 commonly used drugs, oxybutynin and propantheline. Of the 34 patients entered into the trial 19 were treated with oxybutynin and 15 with propantheline. The urological symptoms (frequency, nocturia, hesitancy, urgency and urge incontinence) were graded according to severity from 0 to 3. Patients with urinary infection were excluded. Urodynamic examination, consisting of cystometrography and electromyography, was performed in all patients before treatment. Both groups of patients had comparable neurological, urological and urodynamic status before treatment. In 4 patients (21 per cent) treated with oxybutynin and in 4 (27 per cent) treated with propantheline side effects were so severe that the treatment had to be discontinued. Symptomatic response to oxybutynin was good in 10 patients (67 per cent), fair in 2 (13 per cent) and poor in 3 (20 per cent). Propantheline produced good symptomatic results in 4 patients (36 per cent), fair in 1 (9 per cent) and poor in 6 (55 per cent). The mean increase in maximum cystometric capacity on cystometrography was significantly larger in the oxybutynin group than in the propantheline group (144 +/- 115 versus 35 +/- 101). Our results indicate that oxybutynin is more effective than propantheline in the treatment of detrusor hyperreflexia in patients with multiple sclerosis.
Asunto(s)
Ácidos Mandélicos/uso terapéutico , Esclerosis Múltiple/complicaciones , Parasimpatolíticos/uso terapéutico , Propantelina/uso terapéutico , Vejiga Urinaria Neurogénica/tratamiento farmacológico , Femenino , Humanos , Masculino , Ácidos Mandélicos/efectos adversos , Propantelina/efectos adversos , Estudios Prospectivos , Distribución Aleatoria , Vejiga Urinaria/fisiopatología , Vejiga Urinaria Neurogénica/etiología , Vejiga Urinaria Neurogénica/fisiopatología , UrodinámicaRESUMEN
For more than 30 years nitrofurantoin has been a widely prescribed and effective agent in the treatment of urinary tract infections. During this time, it has withstood the rigors of constant clinical evaluation and has competed successfully with more recent antibacterial agents. As with many widely used drugs, some serious and potentially hazardous reactions to therapy have been documented. This article reviews and analyzes major reported reactions and interactions from both published and unpublished sources. Incidence rates have been calculated for pulmonary, hepatic, neurological, and hematological responses. Calculated rates of occurrence were very low, and ranged from 0.001 percent of courses of therapy (all types of pulmonary reactions combined) to 0.0007 percent (neurological reactions). Reports on interactions of nitrofurantoin with alcohol, antacids, and oral contraceptives are unfounded and anecdotal. Interactions with nalidixic and oxolinic acids are not clinically significant, and only one case of interaction has been reported with phenytoin. Bioavailability is enhanced by food or propantheline. False positives occur with Benedict's test for urine glucose estimations.
Asunto(s)
Nitrofurantoína/efectos adversos , Anemia Hemolítica/inducido químicamente , Antiácidos/efectos adversos , Disponibilidad Biológica , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Anticonceptivos Hormonales Orales/efectos adversos , Interacciones Farmacológicas , Etanol/efectos adversos , Alimentos , Glucosuria/diagnóstico , Humanos , Enfermedades Pulmonares/inducido químicamente , Enfermedades Pulmonares/epidemiología , Ácido Nalidíxico/efectos adversos , Nitrofurantoína/metabolismo , Ácido Oxolínico/efectos adversos , Fenitoína/efectos adversos , Polineuropatías/inducido químicamente , Propantelina/efectos adversosRESUMEN
In five patients developing axillary contact dermatitis subsequent to the use of an antiperspirant containing propantheline bromide patch testing was performed. Three patients reacted to propantheline bromide. The other two patients exhibited positive patch test reactions to the proprietary product; in these cases, the active ingredient was not tested individually. In all five patients, in addition to the antiperspirant, at least one other contact allergen was identified. In case of localized adverse reactions due to topical treatment of hyperhidrosis axillaris patch testing is recommended. If contact allergy to propantheline bromide is revealed, one should be aware of cross sensitization to methantheline bromide.
Asunto(s)
Propantelina/efectos adversos , Adulto , Fenómenos Químicos , Química , Dermatitis por Contacto/etiología , Femenino , Humanos , Hiperhidrosis/tratamiento farmacológico , Inmunización , Masculino , Persona de Mediana Edad , Pruebas CutáneasRESUMEN
The literature on cimetidine drug interactions has been thoroughly reviewed. Several different mechanisms have been proposed for cimetidine-related drug interactions. These mechanisms include: (1) impaired hepatic drug metabolism due to inhibition of hepatic microsomal enzymes, (2) reduced hepatic blood flow, resulting in decreased clearance of drugs that are highly extracted by the liver, (3) increased potential for myelosuppression when administered concurrently with other drugs capable of causing myelosuppression, and (4) altered bioavailability of acid-labile drugs. Cimetidine binds reversibly to the hepatic cytochrome P-450 and P-448 systems, resulting in decreased metabolism of drugs that undergo Phase I reactions (e.g., dealkylation and hydroxylation). In contrast, glucuronidation pathways are unaffected. The rapid onset and reversal of cimetidine's inhibition of hepatic metabolism indicates an effect on hepatic enzyme systems. Cimetidine also has been reported to decrease hepatic blood flow. Drugs that are highly extracted by the liver, such as propranolol, lidocaine, and morphine, may be postulated to have a decreased hepatic clearance. Cimetidine, through its effect on gastric pH, may increase the absorption of acid-labile drugs or may decrease the absorption of drugs. There have been reports of increased potential for myelosuppression when cimetidine is administered concurrently with drugs capable of causing bone marrow suppression. An understanding of the mechanisms involved in cimetidine drug interactions allows the clinician to prevent and predict these interactions.
Asunto(s)
Cimetidina/efectos adversos , Guanidinas/efectos adversos , Antagonistas Adrenérgicos beta/efectos adversos , Animales , Ansiolíticos/uso terapéutico , Antibacterianos/efectos adversos , Benzodiazepinas , Dieta , Interacciones Farmacológicas , Glucosa/efectos adversos , Antagonistas de los Receptores Histamínicos H1/efectos adversos , Humanos , Imidazoles/efectos adversos , Insulina/efectos adversos , Cetoconazol , Metoclopramida/efectos adversos , Microsomas Hepáticos/enzimología , Oxigenasas de Función Mixta/antagonistas & inhibidores , Fenobarbital/efectos adversos , Fenitoína/efectos adversos , Piperazinas/efectos adversos , Propantelina/efectos adversosRESUMEN
Seventy-one patients with duodenal ulcer disease completed a 3- to 6-week controlled randomized trial in which cimetidine (1 g daily) was compared with an optimally effective dose of propantheline. Both groups had free access to an antacid suspension. There were no significant differences between the groups concerning ulcer healing, relief of ulcer symptoms, antacid consumption, or patient compliance. After 3 weeks of treatment, endoscopic examination revealed complete ulcer healing in 63% of the cimetidine and 47% of the propantheline treated patients. The corresponding figures after 6 weeks were 94% and 86%, respectively. After 12 weeks, ulcer recurrence was confirmed in 26% of the cimetidine- and 23% of the propantheline-treated patients. Except for the absence of anticholinergic adverse reactions, no significant advantages could be confirmed for combined cimetidine and antacid treatment.
Asunto(s)
Antiácidos/uso terapéutico , Cimetidina/uso terapéutico , Úlcera Duodenal/tratamiento farmacológico , Guanidinas/uso terapéutico , Propantelina/uso terapéutico , Adulto , Anciano , Cimetidina/efectos adversos , Ensayos Clínicos como Asunto , Quimioterapia Combinada , Endoscopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/tratamiento farmacológico , Cooperación del Paciente , Propantelina/efectos adversos , Píloro , Úlcera Gástrica/tratamiento farmacológicoRESUMEN
After a treatment of 6 months with the antiperspirant Hydonan a contact dermatitis was found in the axillae of a 42 year-old soldier. Hydonan is a combination of 2 emphatic substances: aluminium hydrochloride and propantheline bromide. Aluminium hydrochloride is an adstringence substance, propantheline bromide is a topical active anticholinergic agent. As side-effect an irritation due to aluminium hydrochloride and a contact allergy due to propantheline bromide can occur. In our case there was a contact allergy to propantheline bromide 5% aq.
Asunto(s)
Dermatitis por Contacto/etiología , Fármacos Dermatológicos/efectos adversos , Propantelina/efectos adversos , Adulto , Dermatitis por Contacto/diagnóstico , Humanos , Hipersensibilidad Tardía/inducido químicamente , Masculino , Pruebas CutáneasRESUMEN
This report summarizes the results of nine diagnostic radiographic studies done double blind crossover comparing glucagon to placebo and to anticholinergic drugs in volunteers. In seven studies the subjects were administered drug intramuscularly and in two studies intravenously. There were five diagnostic studies of the upper gastrointestinal tract, one for esophageal varices and three of the colon. The results indicate that glucagon can be given intramuscularly and intravenously. When given intravenously it has a rapid onset and predictable length of action depending on the dose given. Reports of side effects were few consisting primarily of nausea and or vomiting. These results indicate that glucagon is the drug of choice for hypotonic diagnostic examinations.
Asunto(s)
Sistema Digestivo/diagnóstico por imagen , Motilidad Gastrointestinal/efectos de los fármacos , Glucagón/farmacología , Atropina/efectos adversos , Atropina/farmacología , Disponibilidad Biológica , Ensayos Clínicos como Asunto , Colon/efectos de los fármacos , Sistema Digestivo/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Glucagón/administración & dosificación , Glucagón/efectos adversos , Glucagón/metabolismo , Humanos , Masculino , Placebos , Propantelina/efectos adversos , Propantelina/farmacología , RadiografíaRESUMEN
Measurement of changes in buccal mucosal potential difference produced by contact with drug formulations may provide a means of predicting their mucosal toxicity and ulcerogenic activity.