Effect of Premedication on Drug Absorption and Gastric Emptying

Todd, J.G.; Nimmo, W.S.

doi:10.1097/00132582-198406000-00014

Cited by 18 publications

(39 citation statements)

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“…Opioids delay gastric emptying (Todd & Nimmo, 1983), probably making inhalation of gastric contents more likely. A drug which reversed this effect of opioids without reducing analgesia, might be of considerable value in surgical patients.…”

Section: Introduction Methodsmentioning

confidence: 99%

Comparison of the effect of cisapride and metoclopramide on morphine‐ induced delay in gastric emptying.

Rowbotham

Bamber

Nimmo

1988

Brit J Clinical Pharma

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1. The effects of metoclopramide or cisapride on morphine‐induced delay in gastric emptying in patients before surgery were compared. 2. Forty patients were allocated randomly to receive one of four premedications i.m.: placebo only, morphine 10 mg alone, morphine 10 mg with metoclopramide 10 mg and morphine 10 mg with cisapride 10 mg. Gastric emptying after each premedication was assessed indirectly from the rate of absorption of oral paracetamol. 3. Cisapride 10 mg reversed the delay in gastric emptying due to morphine. Its effects were significantly greater than those of metoclopramide 10 mg.

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Section: Introduction Methodsmentioning

confidence: 99%

Comparison of the effect of cisapride and metoclopramide on morphine‐ induced delay in gastric emptying.

Rowbotham

Bamber

Nimmo

1988

Brit J Clinical Pharma

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“…In a substantial proportion of cases, the patient has concomitantly overdosed one or more other drugs in addition to paracetamol [2,3,6,7]. Such drugs may affect the outcome of the paracetamol intoxication as a result of pharmacokinetic interaction with paracetamol or through independent toxic or hepato-protective properties [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Drug interactions with paracetamol may lead to reduced as well as enhanced hepatotoxicity.…”

Section: Introductionmentioning

confidence: 99%

“…Drug interactions with paracetamol may lead to reduced as well as enhanced hepatotoxicity. Suggested mechanisms of interaction include an increased or reduced rate of absorption of paracetamol, reduced conjugation of paracetamol, depletion of glutathione, and inhibition of cytochrome P450-mediated metabolism [9][10][11][12][13][14][15][16]. Independent hepatoprotective mechanisms may involve antioxidant, membrane stabilizing, or calcium channel blocking properties of drugs [17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the same drug may have several and even opposing effects on the paracetamol intoxication [22]. In addition, the effects may vary with the timing and dosing of the drug [10,17,23]. Drugs with interactions leading to reduced hepatotoxicity may potentially be useful as antidotes in paracetamol poisoning [15].…”

Section: Introductionmentioning

confidence: 99%

“…Data on the effect of other drugs on paracetamol intoxication mainly result from animal studies [24], although interaction studies in humans receiving therapeutic doses of paracetamol have been performed and suggest a range of possible mechanisms [9,10,16,22,[25][26][27][28]. In addition, a few observational studies have been made of the effect of concomitant medication or overdosing on paracetamol toxicity in humans [7,29].…”

Section: Introductionmentioning

confidence: 99%

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Concomitant overdosing of other drugs in patients with paracetamol poisoning

Schmidt¹,

Dalhoff

2002

Brit J Clinical Pharma

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Aims Paracetamol is frequently involved in intended self‐poisoning, and concomitant overdosing of other drugs is commonly reported. The purpose of the study was to investigate further concomitant drug overdose in patients with paracetamol poisoning and to evaluate its effects on the outcome of the paracetamol intoxication. Methods Six hundred and seventy‐one consecutive patients admitted with paracetamol poisoning were studied and concomitant drug intake was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, hepatic dysfunction, liver cell damage, and renal dysfunction associated with concomitant overdosing of other drugs was evaluated by multivariate analysis. Results Concomitant drug overdose was found in 207 patients (31%, 95% confidence interval [CI] 27, 34%). Concomitant overdosing of benzodiazepines (99 cases), opioid analgesics (38 cases), acetylsalicylic acid (33 cases), and NSAID (32 cases) predominated. Concomitant benzodiazepine overdose was an independent risk factor in the development of hepatic encephalopathy (odds ratio [OR] 1.91; CI 1.00, 3.65) and renal dysfunction (OR 1.81; CI 1.00, 3.22). Concomitant overdosing of opioid analgesics was a protective factor in the development of hepatic encephalopathy (OR 0.26; CI 0.07, 0.96). Concomitant acetylsalicylic acid overdose was a risk factor in the development of hepatic encephalopathy (OR 4.87; CI 1.52, 15.7) and death or liver transplantation (OR 6.04; CI 1.69, 21.6). A tendency towards a more favourable outcome was observed in patients with concomitant NSAID overdose. Conclusions Concomitant overdosing of benzodiazepines or analgesics is frequent in patients admitted with paracetamol poisoning. Concomitant benzodiazepine or acetylsalicylic acid overdose was associated with more severe toxicity, whereas concomitant overdosing of opioid analgesics was associated with less toxicity.

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Gastrointestinal transit of liquids in unfed cynomolgus monkeys

Kondo¹,

Takahashi²,

Watanabe³

et al. 2003

Biopharm & Drug Disp

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In this study, the gastric emptying rate and oro-caecal transit time of two liquid volumes (20 and 60 ml) were compared in unfed cynomolgus monkeys. First, the acetaminophen method was used to determine the gastric half-emptying time (t(50%)). The mean t(50%) from seven monkeys was 21.2 min for the 20-ml volume and 27.8 min for the 60-ml volume. This mean t(50%) in monkeys is similar to that reported previously in fasting humans. Next, the sulfasalazine-sulfapyridine method was used to determine median oro-caecal transit times for the 2 liquid volumes; these times were 2.5 h for the 20-ml volume and 2.3 h for the 60-ml volume, which are about 1.5 h shorter than previously reported transit times in humans. An increase in volume administered did not significantly change either the t(50%) or oro-caecal transit time. The data also show that variability in both t(50%) and oro-caecal transit time within each monkey is not as great as the large variability between monkeys. Consequently, cynomolgus monkeys are good model animals to use for studies on the gastric emptying of drug-containing liquids after fasting; however, analysis of results from bioavailability studies must compensate for differences in the oro-caecal transit time between monkeys and humans.

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Effect of Premedication on Drug Absorption and Gastric Emptying

Cited by 18 publications

References 0 publications

Comparison of the effect of cisapride and metoclopramide on morphine‐ induced delay in gastric emptying.

Comparison of the effect of cisapride and metoclopramide on morphine‐ induced delay in gastric emptying.

Concomitant overdosing of other drugs in patients with paracetamol poisoning

Gastrointestinal transit of liquids in unfed cynomolgus monkeys

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