Effectiveness of Cisapride in Gastric Ulcer Results of a Double-Blind Randomized Trial Versus Ranitidine and Versus Cisapride plus Ranitidine

Testoni, P.A.; Bagnolo, F.; Buizza, M.; Masci, E.; Toti, G. L.; Spinelli, Antonino; Manzi, G.

doi:10.1097/00004836-199307000-00003

Cited by 8 publications

(5 citation statements)

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“…Some prokinetic benzamides like metoclopramide have been effective in experimental models of gastric ulceration (Gupta et al 1989). Preliminary studies have shown that cisapride, a potent benzamide stimulating gastrointestinal motility, was effective in healing ulcers and could prevent ulcer relapse after healing (Simon et al 1990;Kerrigan et al 1993;Testoni et al 1993;Wiseman & Faulds 1994).…”

mentioning

confidence: 99%

The role of Gastric Mucosal Sulphydryls in the Ulcer-protecting Effects of Cisapride

López¹,

Motilva²,

Lastra³

et al. 1996

Journal of Pharmacy and Pharmacology

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The present study was designed to examine the role of endogenous sulphydryls (SHs) in the gastro-protection induced by cisapride (CIS) (10, 25 and 50 mg kg-1 i.p.), a potent benzamide stimulating gastrointestinal motility in mucosal injury induced by 50% v/v ethanol. Results were compared with those of 5-hydroxytryptamine (5-HT) (10mg kg-1). Ethanol mucosal damage was significantly reduced by treatment with CIS and 5-HT. On the contrary, administration of n-ethylmaleimide (NEM) (10 mg kg-1) an SH alkylator, markedly worsened lesion formation and counteracted the protective effect of CIS. Rats pretreated with CIS significantly increased the total sulphydryls as reflected in the non-protein and protein fractions however, 5-HT treatment showed a fall in the non-protein level. The present results suggest that 5-HT-ergic dependent mechanisms have no relation to the gastro-protection afforded by CIS in this experimental model. It is possible that mucosal SHs could be involved.

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mentioning

confidence: 99%

The role of Gastric Mucosal Sulphydryls in the Ulcer-protecting Effects of Cisapride

López¹,

Motilva²,

Lastra³

et al. 1996

Journal of Pharmacy and Pharmacology

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“…Although paracetamol is most commonly used as an analgesic and antipyretic, it has also been used to measure gastric emptying because it appears to be absorbed much more rapidly from the small intestine than from the stomach (Heading et al 1973). The conventional oral dose of paracetamol for adults is 1 g, with total daily dosage not exceeding 4 g. Cisapride improves deranged gastrointestinal motility and reduces duodenogastric reflux (Testoni et al 1993). It also speeds gastric emptying in normal subjects and in insulin-dependent diabetics with delayed gastric emptying (Horowitz et al 1987 ;Lazzaroni et al 1987).…”

Section: Discussionmentioning

confidence: 99%

Cisapride raises the bioavailability of paracetamol by inhibiting its glucuronidation in man

Nagano

Takeyama

2001

Journal of Pharmacy and Pharmacology

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The effect of cisapride on plasma concentrations of paracetamol was investigated with respect to hepatic metabolism. Paracetamol (1 g) together with cisapride (7.5 mg) or placebo was orally administered to five healthy male volunteers. Venous blood samples were taken before and after administration. Plasma paracetamol and its glucuronide and sulfate conjugates were measured by HPLC. The pharmacokinetic variables were calculated from the plasma concentration-time curves of each volunteer. The area under the plasma paracetamol concentration-time curve from 0 to 180 min (mean +/- s.d.) increased from 1875.0 +/- 112.8 micrg min mL(-1) (placebo coadministration) to 2238.8 +/- 125.8 microg min mL(-1) (cisapride coadministration) (P < 0.01). The mean maximum plasma paracetamol concentration(18.2 microg mL(-1))with placebo was reached 30 min after administration, whereas mean maximum plasma paracetamol concentration (21.2 microg mL(-1)) with cisapride occurred 45 min after administration. The plasma paracetamol concentrations with cisapride were significantly greater at 45 to 120 min after administration compared with placebo. Plasma paracetamol glucuronide conjugate concentrations with cisapride were decreased at 15 to 60 min compared with placebo (P< 0.05), whereas plasma paracetamol sulfate conjugate concentrations did not change significantly. Hence the coadministration of paracetamol with cisapride reduced plasma paracetamol glucuronide concentrations and increased plasma paracetamol concentrations, presumably due to inhibition of paracetamol metabolism via paracetamol glucuronyltransferase. Thus, care is necessary when paracetamol and cisapride are coadministered.

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“…This drug is shown to be of benefit in GORD [141][142][143][144][145][146][147][148][149][150][151][152] and functional dyspepsia, [153][154][155][156][157][158][159][160] and may have some efficacy in peptic ulcer disease. [161][162][163][164] Recently, however, serious cardiac side effects of cisapride were reported and, for that reason, the drug has been withdrawn from the US market. 165 …”

Section: Immediate Endoscopy or Symptom Guided Empirical Treatmentmentioning

confidence: 99%

A rational approach to uninvestigated dyspepsia in primary care: review of the literature

Arents

Thijs

Kleibeuker

2002

Postgraduate Medical Journal

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In this paper the rationale and limitations of the four most important approach strategies to dyspepsia in primary care (empiric treatment, prompt endoscopy, “test-and-scope”, and “test-and-treat”) are analysed. It is concluded that in the absence of alarm symptoms, a “test-and-treat” approach is currently the most rational approach provided that three conditions are met: (1) a highly accurate test should be used, (2) the prevalence of Helicobacter pylori in the population should not be too low, and (3) an effective anti-H pylori regimen should be prescribed taking sufficient time to instruct and motivate the patient.

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Effectiveness of Cisapride in Gastric Ulcer Results of a Double-Blind Randomized Trial Versus Ranitidine and Versus Cisapride plus Ranitidine

Cited by 8 publications

References 0 publications

The role of Gastric Mucosal Sulphydryls in the Ulcer-protecting Effects of Cisapride

The role of Gastric Mucosal Sulphydryls in the Ulcer-protecting Effects of Cisapride

Cisapride raises the bioavailability of paracetamol by inhibiting its glucuronidation in man

A rational approach to uninvestigated dyspepsia in primary care: review of the literature

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