Hypotonic Roentgenography With Glucagon

Miller, Roscoe E.; Chernish, Stanley M.; Skucas, Jovitas; Rosenak, Bernard D.; Rodda, Bruce E.

doi:10.2214/ajr.121.2.264

Cited by 45 publications

(18 citation statements)

References 19 publications

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“…In addition, glucagon reduces tonicity and motility of the stomach, duodenum, small bowel, and colon, abolishing peristalsis and allowing full visceral distention [5][6][7][8][9], with no effect on esophageal peristalsis…”

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The hypotonic effect of intranasal and intravenous glucagon in gastrointestinal radiology

et al. 1995

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In the present study, following a double-blind, double placebo protocol vs. placebo, we compared the hypotonic effect of intranasal and intravenous glucagon during a double-contrast barium meal examination of the stomach. We found a statistically significant difference between placebo and intranasal or intravenous glucagon in inducing gastric hypomotility, with no significant differences between IN and IV glucagon. The intranasal administration of glucagon has the advantage of being noninvasive and well tolerated by the patients, and might be a valuable aid in upper gastrointestinal examination as well as in CT scan or magnetic resonance imaging of the abdomen.

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The hypotonic effect of intranasal and intravenous glucagon in gastrointestinal radiology

et al. 1995

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“…It has also a number of other actions, including a hypomotility and hypotonicity action on gastrointestinal motility (Stunkard et al, 1955;Sudsaneh et al, 1959;Detevall et al, 1963;Necheles et al, 1966). It is thus now commonly used as a pre-treatment drug for radiodiagnostics (Miller et al, 1974;Kreel et al, 1975;Carsen et al, 1976;Ishii et al, 1978) or endoscopic examinations (Qvigstad et al, 1979) of gastrointestinal tract in patients with complications such as heart diseases (Giesen, 1978;Harada et al, 1997), glaucoma (Sissons et al, 1991;Fink et al, 1995) and hypertrophy of the prostate (Chernish et al, 1972). The enteric nervous system may be a target of glucagon (Takenaka et al, 1975;Lin et al, 1989), but the exact mechanisms of the inhibitory effects have not been elucidated.…”

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Involvement of Cholinergic Motor Neurons in Pharmacological Regulation of Gastrointestinal Motility by Glucagon in Conscious Dogs.

Shimatani

1997

J. Smooth Muscle Res.

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To clarify the exact mechanisms of the pharmacological effects of glucagon on gastro intestinal motility, the following experiments were performed on the conscious and anesthe tized dogs. 1) During phase I of interdigestive migrating contractions (IMC) , glucagon (5 infusion for 5 minutes) induced phasic contractions in the duodenum , jejunum and ileum, but not in the antrum. These excitatory responses were also observed in the truncal vagotomized dogs. These contractions were abolished by atropine or hex amethonium in the conscious dogs, and also by tetrodotoxin in the anesthetized dogs . 2) Glucagon inhibited cisapride-induced contractions only in the antrum in the conscious dogs .After pre-treatment with hexamethonium, glucagon inhibited these contractions in the duodenum, jejunum and ileum as well as in the antrum. After pre-treatment with tetrodotoxin in the anesthetized dogs, glucagon did not affect acetylcholine-induced contrac tions in any region. 3) Glucagon inhibited spontaneous phase III contractions and eryth romycin-induced phase III-like contractions in the antrum, but did not inhibit either contrac tions in the other regions in the conscious dogs. These paradoxical effects of glucagon between the antrum and intestine were similar to those involved in the blockade of 5-hydroxytryptamine 3 receptors. After pre-treatment with hexamethonium , glucagon inhib ited these contractions in the duodenum, jejunum and ileum as well as in the antrum . In conclusion: 1) Glucagon latently inhibits cholinergic motor activities in the antrum and intestine not directly, by binding to either receptor on the smooth muscle cells , but through postganglionic cholinergic neurons and possibly through 5-hydroxytryptamine neurons. 2) On the other hand, in the intestine the reverse effects through preganglionic cholinergic neurons involving nicotinic and muscarinic receptors are more potent . 3) As a result, glucagon inhibits antral contractions and does not affect intestinal contractions in a con scious state.

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“…For the introduction of gas we use the 'bubbly barium' method [8]. Premedication with glucagon (0.25-0.5 mg intravenously) [9,10]. The logical consequence of this method is that we perform many tubeless hypotonic duodenographies, the indication being either the clinical data or the findings observed during the standard examination.…”

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confidence: 99%