EVERAL FACTORS control the rate and amount of S alcohol absorbed during acute oral intake including the rate of gastric emptying and the degree of first-pass metabolism. The putative interaction between some H2-receptor antagonists (H2RA) and alcohol is through inhibition of gastric alcohol dehydrogenase (ADH).4 This increases blood alcohol concentrations (BAC) and the absolute bioavailability of alcohol although the results have produced ~ontention.~-~ On the one hand it has been argued that the frequency of ingestion of alcohol and H2RA makes this a potential major concern' whereas on the other it has been suggested that the interaction is observed only under unusual experimental conditions.5** H2RA are among the most commonly taken drugs worldwide, and alcohol is the most commonly imbibed drug. Since alcohol is one of the commonest determinants of dyspepsia in the population," this issue is a potential public health concern.The objective of the present study was to examine for an interaction between different antisecretory drugs and alcohol at a potentially intoxicating dose. METHODSSix healthy male physicians (mean age 34 years, age range 29 to 42) were given alcohol on six separate occasions following pretreatment in random order with cimetidine 800 mg once daily, ranitidine 300 mg once daily, nizatidine 300 mg once daily, famotidine 40 mg once daily, or omeprazole 20 mg once daily for 6 days prior to each study. Subjects received an additional dose of the study medication on the day of alcohol administration. There was a 6-to 7day washout period between courses of medication.The absorption of alcohol was studied on each occasion after a 6-hr fast and I hr after eating a standard meal (one egg omelet, two slices of toast, and 200 ml of orange juice). Each subject then drank 400 ml of orange juice containing grain alcohol (0.75 g/kg of absolute ethanol equivalent). Blood alcohol levels were measured at 0, 15, 30, 45, 60, 90, and 120 min by gas chromatography. Data were compared using the paired two-tailed Student's t test. Area under the alcohol concentration/ time curve (AUC) was calculated using the linear trapezoidal rule.
To examine the potential benefit of a computer-assisted interview about life-style in gastroenterology practice, 34 consecutive patients attending a gastroenterology clinic were questioned by a computer using software designed to obtain a comprehensive history of alcohol, caffeine, cigarette, and illicit drug use, together with an assessment of exercise, sexual activity, and nutrition. Comparisons of the information obtained by the computer with clinical records revealed that physicians documented only 3% of the patients as problem drinkers, 3% as caffeine abusers, and 17% as smokers, whereas the computer identified 10% of the patients as problem drinkers, 27% as caffeine abusers, and 43% as smokers. These findings imply that patients may be more apt to tell more about adverse life-style to the computer than to a physician during clinical interview. In a sample patient population from a gastroenterology clinic, a microcomputer provides an acceptable, efficient, and potentially cost-effective way to assess life-style.
Simultaneous measurements of the gastric emptying rate of the solid and liquid phase of a dual-isotope-labeled test meal were made using a gamma camera and a simple scintillation detector, similar to that used in a hand-held probe. A simple scanning apparatus, similar to that used in a hand-held scintillation probe, was compared with simultaneous measurements made by a gamma camera in 16 healthy males. A dual-labeled test meal was utilized to measure liquid and solid emptying simultaneously. Anterior and posterior scans were taken at intervals up to 120 min using both a gamma camera and the scintillation probe. Good relative agreement between the methods was obtained both for solid-phase (correlation range 0.92-0.99, mean 0.97) and for liquid-phase data (correlation range 0.93-0.99, mean 0.97). For solid emptying data regression line slopes varied from 0.75 to 1.03 (mean 0.84). Liquid emptying data indicated that slopes ranged from 0.71 to 1.06 (mean 0.87). These results suggested that an estimate of the gamma measurement could be obtained by multiplying the scintillation measurement by a factor of 0.84 for the solid phase and 0.87 for the liquid phase. Correlation between repeat studies was 0.97 and 0.96 for solids and liquids, respectively. The application of a hand-held probe technique provides a noninvasive and inexpensive method for accurately assessing solid- and liquid-phase gastric emptying from the human stomach that correlates well with the use of a gamma camera, within the range of gastric emptying rate in the normal individuals in this study.
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