Erwin Levin

Gastric antacid and anti-secretory drugs: a survey based primarily on their effects upon gastric secretion in man.

Excerpt The medical management of peptic ulcer in large part comprises the use of compounds which either neutralize or inhibit temporarily the output of hydrochloric acid.1The rationale of this tre...

Twelve-hour nocturnal gastric secretion in uncomplicated duodenal ulcer patients : before and after healing.

Conclusions 1. In the same patient with duodenal ulcer the 12-hour nocturnal gastric secretion is usually unaltered with healing of the ulcer. 2. The average 12-hour nocturnal gastric secretion of patients with active ulcer is not significantly different than in patients with healed duodenal ulcer. 3. Twelve-hour nocturnal gastric secretion in patients with healed duodenal ulcer and who are without symptoms is significantly greater than that of normal healthy individuals.

Pamine Bromide: Gastric Antisecretory Effects and Therapeutic Usefulness in Peptic Ulcer and other Gastrointestinal Disorders

Summary Pamine bromide, in single doses of 0.014 to 1.40 mg. intramuscularly, produced anacidity in 25 of 47 patients. Side effects developed with quantities of 0.039 mg. and increased in proportion to the dosage. Pamine produced anacidity in 22 of 57 patients given single doses of 2.5 to 25 mg. intragastrically and in two of six patients receiving 10 to 20 mg. intraduodenally. Side effects were pronounced with doses of 15 mg. or more. Pamine bromide in laminated tablets containing 5 or 10 mg. suppressed gastric secretion temporarily in three of 10 patients. Scopolamine hydrobromide orally in single doses of 0.16 to 2.24 mg. produced anacidity of brief duration in five of 15 patients. Side effects, chiefly drowsiness, developed in 11 of the 15 cases, increasing in proportion to the quantity of scopolamine. Single intramuscular injections of Pamine bromide in doses of 0.13 to 0.23 mg. decreased briefly the continuously-stimulated gastric secretion in six of eight patients. The fasting secretion for one hour, measured at intervals during the prolonged oral intake of Pamine, decreased in 13 of 15 patients. The early clinical response was judged as good or favorable in 74 of 88 patients with peptic ulcer; in six the therapy was considered insufficient. Side effects were reported by 63 of the 88 patients and necessitated discontinuation of the drug in 17. The most frequent symptoms were dryness of the mouth, blurring of vision, and constipation. The side effects decreased or apparently subsided completely during prolonged therapy in 25 patients. Treatment was terminated in 9 additional patients because of poor clinical response, other therapy or unreliability of the patient. Pamine bromide was administered orally to 37 patients with gastrointestinal disease other than peptic ulcer. Decrease in diarrhea and relief of cramping abdominal pain were noted in 11 of 16 patients with functional gastrointestinal disorders, in 7 of 10 patients with regional enteritis and in four of seven patients with severe ulcerative colitis. Symptomatic improvement was noted also in two patients with hiatus hernia and heartburn and in one individual with the post-gastrectomy syndrome. Pamine was ineffective in the one patient with chronic recurrent pancreatitis. Side effects were reported by 25 of the 37 patients in this category; in 11 cases their severity necessitated discontinuation of the drug. Treatment was terminated in eight additional patients because of inadequate clinical response. The occurrence and severity of the side effects varied greatly among individual cases. Pamine has been continued in 80 of the 125 patients. Side effects apparently were absent in 27, and were interpreted as mild in 26, moderate in 20 and severe in 7 patients. Among the 45 patients in whom Pamine was discontinued, therapy was terminated in 28 because of side effects; no attempt was made to reduce the initial dose in these patients. In 17 cases Pamine was discontinued for other reasons, principally inadequate clinical response. The prolonged oral intake of Pamine did not produce demonstrable toxic effects upon the blood, urine, hepatic function or the electrocardiogram.

The Continuous Twelve-Hour Nocturnal Gastric Secretion in Normal Individuals and in Patients With Duodenal Ulcer After a 24-Hour Fast

A recent studyl. 2 demonstrated that the volume, concentration and output of acid in the nocturnal gastric secretion are usually higher in patients with duodenal ulcer than in normal healthy individuals. Several observers have suggested that the test meal given at 5:30 P.M. in this study, although low in protein and carbohydrate, may be a contributing factor in causing the hypersecretion in duodenal ulcer patients. This opinion is based on the assumption that patients with duodenal ulcer have a greater secretory response to the same stimulus than normal individuals. It seemed desirable, therefore, to measure the continuous nocturnal gastric secretion after a fast of one day in a group of normal individuals and patients with duodenal ulcer.

The effect of banthine on gastric secretion in man.

The use of Banthine in the treatment of peptic ulcer has aroused considerable interest. Hambourger1 and Longino et al. 2 ascribed to Banthine a blocking action at the parasympathetic postganglionic nerve endings and possible anticholinergic properties at the synapses of the peripheral autonomic ganglia. Subsequent studied of the effect of Banthine upon gastric secretion have yielded variable results.3s The present study was undertaken to clarify this problem.

The nocturnal gastric secretion in patients with benign gastric ulcer.

Excerpt INTRODUCTION The results of studies on the nocturnal gastric secretion of normal individuals and of patients with duodenal ulcer, gastric ulcer and gastric carcinoma have been summarized in...

Benign Gastric Ulcer with Apparent Achlorhydria

The purpose of this paper is to present three cases of benign gastric ulcer demonstrating that: (1) profound depression of parietal cell function, either spontaneous or induced by roentgen irradiation to the stomach, may occur temporarily; (2) this depression may be so profound that stimulation by the usual amounts of histamine dihydrochloride (.01 mg. of the base per Kg. of body weight) is inadequate to elicit acid secretion; (3) that repeated standard histamine tests may not establish the presence of true achlorhydria and, (4) that in such cases one must resort either to the continuous itdministration of histamine or to the use of both alcohol and histamine to demonstrate the secretion of acid.

Effect of dibuline on nocturnal gastric secretion in man.

Conclusions The effect of dibuline on gastric secretion is variable, transitory, and unpredictable. Further trial of the drug in the treatment of peptic ulcer seems to us unwarranted.

Effect of Dialyzed Enterogastrone Upon Twelve-Hour Nocturnal Gastric Secretion in Man.

Conclusions 1. The output of hydrochloric acid in the 12-hour nocturnal gastric secretion of 4 patients with peptic ulcer was unchanged following the intramuscular administration of 200 to 2000 mg of a dialyzed preparation of enterogastrone. 2. Gastric secretion was reduced slightly in one and markedly in five of six patients with peptic ulcer, given 5000 mg. The transitory inhibition consisted chiefly of a decrease in the concentration of acid and, to a lesser extent, of the volume of secretion.

Effect of Non-Specific Protein (Aolan) upon Twelve-Hour Nocturnal Gastric Secretion in Man,

Summary The output of hydrochloric acid in the 12-hour nocturnal gastric secretion of 10 patients with peptic ulcer, following the intramuscular injection of 20 cc of a sterile lactalbumin solution, was unchanged in 3 cases, decreased slightly in 1 and increased in 6 patients. These results suggest that the temporary reduction in gastric secretion occasionally observed during the administration of enterogastrone is not attributable to a nonspecific action of the proteins present in the concentrate.