Banthine for peptic ulcer: Clinical and physiologic considerations

Winkelstein, A

doi:10.1016/s0016-5085(52)80184-2

Cited by 13 publications

(6 citation statements)

References 3 publications

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“…If one surveys, however, the recorded work on the effect of anticholinergic drugs on hypoglycaemic stimulated secretion, it is found that many workers have found that the acid output is unaffected (Bayer and Bradford, 1952;Bayer, Plummer, and Bradford, 1952;Levin, Kirsner, and Palmer, 1952;Winkelstein, 1952;Roback and Beal, 1953;Weisiger, Burke, and Plummer, 1954;McKenna, Smith, and Wyse, 1954;Kasich, Boleman, and Rafsky, 1956;Bachrach, 1958). Others, nevertheless, have observed an inhibitory effect (Lieber, 1956;Plummer, Burke, and Bradford, 1951;Rock and Rohrer, 1958) and our own observations support these findings (Piper, Elliott, Sietsma, and Pryor, 1960).…”

Section: Discussionsupporting

confidence: 62%

A comparison of a series of newer anticholinergic agents with atropine as regards their effect on saliva flow and gastric secretion in man

Piper¹,

Stiel²

1962

Gut

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SYNOPSISThe effect of anticholinergic agents-atropine, propantheline, oxyphencyclimine, and propionyl atropine methyl nitrate-on saliva flow and on hypoglycaemic stimulated gastric secretion has been studied. The acid secretion of the nervous phase of gastric secretion was inhibited by anticholinergic drugs. They influenced gastric secretion to a greater extent than saliva flow.Both propantheline and oxyphencyclimine have a selective action on the stomach superior to atropine. Propionyl atropine methyl nitrate appears to have only weak anticholinergic activity in the dose recommended and is not superior to atropine.Anticholinergic drugs are widely used in the treatment of peptic ulcer and with this aim new preparations are constantly being produced. One of the advantages over atropine claimed for the newer preparations is that they produce fewer side-effects, which implies that they have a selective action on the stomach. Apart from one French study (Lieber, 1956) that showed that the more recently developed preparations were inferior to atropine in this respect, there is no work in man, supported by the quantitative determination of their effect on gastric secretion and of their side-effects, comparing atropine with the newer anticholinergic agents.Because of the importance of whether or not the newer drugs have a selective action on the stomach, the present study was undertaken. Atropine and three new preparations (propantheline, oxyphencyclimine, and propionyl atropine methyl nitrate) were compared as regards their effect on saliva flow and on hypoglycaemic stimulated gastric secretion. METHODFor several reasons it was not possible to determine both responses in the same group of patients. Consequently one group of volunteers was studied as regards saliva flow and a second group as regards gastric secretion; the results were then analysed statistically.Saliva flow was stimulated by chewing. Gum devoid of the outer flavoured coat was used; the gum was chewed for 10 minutes and the volume of saliva secreted measured.Three control readings were taken and subsequently readings at hourly intervals after the administration of the drug until saliva flow returned to normal. Side-effects, particularly the presence of a dry mouth, blurred vision, or difficulty in micturition were noted. The volunteers used in this study were members of the resident medical staff; seven such studies were made.The effect on gastric secretion was determined using hypoglycaemic stimulated secretion. For this, patients having insulin coma therapy for psychiatric reasons were used. After fasting, the drug was given between 6.30 a.m. and 6.45 a.m. followed by a large dose of insulin (the dosage ranged between 200 and 1,600 units). The patient went into coma two to two and a half hours after the administration of insulin and spent one hour in coma. Coma was considered to be present when the patient no longer responded to painful stimuli and extensor plantar responses were present. It had previously been determined that under these conditions c...

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Section: Discussionsupporting

confidence: 62%

A comparison of a series of newer anticholinergic agents with atropine as regards their effect on saliva flow and gastric secretion in man

Piper¹,

Stiel²

1962

Gut

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“…McHardy also found that the average time before pain was relieved was shortened from 75 hours to 32 hours. Winkelstein (1952) noted that 87 per cent of 103 duodenal ulcer patients lost their symptoms at once. Gastric and jejeunal ulcer patients also had prompt relief.…”

Section: Results In American Seriesmentioning

confidence: 99%

“…Twenty‐two out of 29 craters healed radiologically after continued methantheline therapy. Winkelstein (1952) reported 75 per cent of 71 patients to have healing of ulcer niche. On the other hand Liebowitz showed that ulcer craters could develop during treatment.…”

Section: Results In American Seriesmentioning

confidence: 99%

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Methantheline Bromide in the Treatment of Duodenal Ulcer

Davis

1953

Int J Clinical Practice

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“…The therapeutic effect of methantheline for peptic ulcer was studied by Winklestein in a rather large series of patients with peptic ulcer (14). He used a dosage of 50 mg., 3 times a day before meals, at bedtime, and once during the night, in the management of 117 patients with what he termed uncom plicated but refract<�ry peptic ulcer.…”

Section: Gastric Physiologymentioning

confidence: 99%