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In the present studies we investigated the mechanism of action of prostaglandin E2 (1 mg/kg, i.p.) to induce emesis and defecation and/or tenesmus in the ferret. The emesis was antagonized significantly (P<0.05) by ondansetron (0.3 and 1 mg/kg, i.p.) and (+)-(2S,3S)-3-(2-methoxybenzylamino)-2-phenlypiperidine hydrochloride (CP-99,994; 10 mg/kg, i.p.), but neither compound reduced defecations and/or tenesmus, with ondansetron (0.3 mg/kg) actually producing a slight increase (P<0.05). Droperidol (1 and 3 mg/kg), metoclopramide (0.3 and 3 mg/kg), domperidone (0.3 and 3 mg/kg), promethazine (0.3 and 3 mg/kg) and scopolamine (0.3 and 3 mg/kg) failed to reduce prostaglandin E2 induced emesis. However, droperidol (1 and 3 mg/kg) and scopolamine (0.3 and 3 mg/kg) reduced significantly the defecatory and/or tenesmus response (P<0.05). Bilateral abdominal vagotomy was ineffective to reduce emesis and defecations and/or tenesmus. The data suggests that 5-HT3 receptor and NK1 tachykinin receptor antagonists could be useful in the clinic to prevent emesis but not defecations induced by prostaglandin E2.
Domperidone has been used as a gastrokinetic and anti-emetic drug within the frames of an intensive care programme in 57 patients with a history of 3-4 days of acute myocardial infarction. According to the observations, Motilium prevents the development of gastroduodenal complaints and nausea, vomiting in a period following the first days of acute therapy and promotes the start of bowel movement and defecation. It has no cardiac or other toxic effects and does not influence the action of other drugs.
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1. An intracellular recording study was performed to elucidate the mechanism underlying D1 and D2 receptor-mediated inhibition of neuronal activities of dopaminergic neurones in the ventral tegmental area (VTA) using slice preparations of the rat brain. 2. VTA neurones were classified into type I and type II neurones according to the shape of the action potential, which correspond to dopaminergic and non-dopaminergic neurones, respectively. 3. Addition of dopamine (10 microM) and quinpirole (1-100 microM) to the bath hyperpolarized the membrane of the type I neurones concomitantly with an increase in membrane conductance and an inhibition of action potentials which occurred spontaneously and were elicited by depolarizing pulses applied to the cell. However, quinpirole (10 microM) had no effect on the threshold for action potentials induced by a depolarizing pulse. 4. These quinpirole (10 microM)-induced effects were antagonized by simultaneous application of domperidone (5 microM), a D2 receptor antagonist. 5. The amplitude of quinpirole (10 microM)-induced hyperpolarization was decreased by increasing the potassium concentration in the perfusing fluid or simultaneous application of tetraethylammonium (10 microM). 6. SKF 38393 (10 or 100 microM), a D1 receptor agonist, had no effect on the resting membrane potential or action potential firing induced by a depolarizing pulse applied to the cell. However, when SKF 38393 (10 microM) was applied simultaneously with quinpirole (10 microM), the threshold for action potential generation was elevated by 5-6 mV, although there was no enhancement of hyperpolarization induced by quinpirole. 7. The elevation of the threshold for action potentials induced by SKF 38393 in the presence of quinpirole was antagonized by simultaneous application of SCH 23390 (5 microM), a D1 receptor antagonist.8. Dopamine (10 microM), quinpirole (10 or 100 microM) and SKF 38393 (10 or 100 microM) had no effect on the resting membrane potential or spontaneously occurring action potentials in type II neurones.9. These findings suggest that activation of dopamine D2 receptors of dopaminergic neurones in the VTA increases potassium conductance, thereby hyperpolarizing the membrane and eventually inhibiting neuronal activities. They also suggest that simultaneous activation of both D1 and D2 receptors enhances the D2 receptor-mediated inhibitory effects by elevation of the threshold for action potential generation.
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The focus was on haloperidol (central dopamine antagonist)-stomach lesion, a longly described suitable counterpart of dopamine blocker cysteamine-duodenal lesion. In this, the contribution of blockade of central/peripheral dopamine receptors and prostaglandins synthesis, along with influence of antiulcer agents was evaluated in mice. Male NMRI Hannnover mice were sacrificed 24 h after haloperidol (25 mg/kg b.w. i.p., given alone or with saline (haloperidol+saline) (i) or in combination (ii,iii)). Supporting central dopamine predominance for haloperidol stomach lesion induction, co-administration of peripheral dopamine receptor antagonist domperidone (5 mg/kg i.p.) (haloperidol+ domperidone) (ii), or prostaglandin synthesis inhibitor indomethacin (10 mg/kg s.c.) (haloperidol+ indomethacin) (iii) did not aggravate this lesion. (i) In haloperidol+saline challenged mice the lesions were inhibited by co-administration (/kg i.p.) of a gastric pentadecapeptide BPC 157, GlyGluProProProGlyLysProAlaAspAspAlaGlyLeuVal, M.W. 1419 (10 microg, 10 ng, 10 pg, but not 1 pg, 100 fg, 10 fg), bromocriptine (10 mg), omeprazole (10 mg, 100 mg, but not 1 mg). Atropine (10, 100, 200 mg), pirenzepine (10, 100, 200 mg), misoprostol (10, 100, 200 microg), pantoprazole (1, 10, 100 mg), lansoprazole (0.1, 1, 10 mg), cimetidine (10, 100, 200 mg) and ranitidine (10, 100, 200 mg) were not effective. (ii) Dopamine peripheral blockade influence: in haloperidol+domperidone mice, previously effective bromocriptine, pentadecapeptide BPC 157 (10 microg) or omeprazole (10 mg) did not attenuate stomach lesions. (iii) Prostaglandins synthesis blockade effect: in haloperidol+indomethacin mice, previously effective agents, bromocriptine or omeprazole were not active, while BPC 157 effect was only lessened.
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Agonists of dopamine receptors can lower blood pressure by vasodilation through action on dopamine1 receptors, inhibition of sympathetic nerve activity by action on dopamine2 receptors, or actions in the central nervous system. Fenoldopam, a selective dopamine1 agonist, piribedil, a selective dopamine2 agonist, and dipropyl dopamine, a mixed dopamine1 and dopamine2 agonist, were injected intravenously in pentobarbital-anesthetized, spontaneously hypertensive rats (SHR). The mechanism for the antihypertensive effect was evaluated by administration of the selective dopamine1 antagonist SCH 23390 and the selective dopamine2 antagonist domperidone. While SCH 23390 only antagonized the hypotensive effects of fenoldopam, domperidone abolished the fall in blood pressure produced by dipropyl dopamine and piribedil but not by fenoldopam. Increments in heart rate and plasma norepinephrine levels accompanied the hypotensive effects of fenoldopam. The increase in heart rate was abolished by a dose of SCH 23390 sufficient to completely block the hypotensive effects and was significantly attenuated by the ganglionic blocking agent hexamethonium, which suggests that the increase in heart rate was due to a baroreceptor reflex. Fenoldopam does not cross the blood-brain barrier, which suggests that its hypotensive effect was mediated by peripheral dopamine1 receptors. Since domperidone does not cross the blood-brain barrier and significantly antagonized the hypotensive and bradycardic effects of dipropyl dopamine and piribedil, these effects were mediated primarily by peripheral dopamine2 receptors. These results indicate that SCH 23390 and domperidone are useful agents to identify the receptor subtype mediating the action of dopamine agonists in SHR.
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Several dopamine agonists, administered i.m., produced persistent, excessive and non-localized scratching in squirrel monkeys (Saimiri sciureus). Studies were conducted with a series of drugs to determine the pharmacological mechanisms responsible for this effect. All of the dopamine D2 agonists studied produced dose-related increases in scratching, whereas several dopamine D1 receptor agonists, indirect dopamine agonists and drugs acting on other receptors failed to produce dose-related increases in scratching. The scratching produced by D2 agonists was stereospecific; (-)-NPA produced scratching whereas its (+)-enantiomer was inactive up to doses 300-fold higher. Scratching induced by quinpirole was attenuated by both D2 and D1 antagonists, and this antagonism was stereospecific, with the D2 antagonist (-)-eticlopride, but not its enantiomer, active. Sensitivity developed to the effects of D2 agonists with the quinpirole dose-effect curve shifting to the left by a factor of approximately 64. Two partial D2 receptor agonists (SDZ 208-911 and SDZ 208-912) had limited efficacy in producing scratching, however, one partial D2 receptor agonist (terguride) was fully efficacious, suggesting that there are spare receptors for this effect. The peripherally active dopamine antagonist domperidone and the histamine antagonist diphenhydramine also reduced the scratching induced by D2 agonists, but not to the same extent as centrally acting D2 antagonists. Scratching in squirrel monkeys is an effect that appears to be due to agonist actions at D2 receptors, and may be mediated by a release of histamine. This behavioral activity may be useful as an in vivo indication of D2 receptor activity in primates.
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Topical administration of B-HT 920 (50 micrograms) to the eyes of normal unanesthetized cats produced decreases in intraocular pressure and pupil diameter. The ocular hypotensive effect of B-HT 920 was eliminated by sympathectomy and pretreatment with sulpiride (2 mg/kg, s.c.). B-HT 920 also produced dose-related inhibition of contractions of the cat nictitans elicited by stimulating the pre- and postganglionic sympathetic trunks. B-HT 920-induced suppression of the contracting nictitans was antagonized more effectively by relatively selective DA2 antagonists, sulpiride and domperidone, than by rauwolscine, a relatively selective alpha 2-adrenoceptor antagonist. These data suggest that B-HT 920 produces ocular hypotension in the cat by interacting predominantly with DA2 receptor on peripheral sympathetic nerves.
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Five patients with idiopathic Parkinson's disease with severe response fluctuations were selected for a randomized double-blind placebo-controlled study, concerning the clinical effects of subcutaneous apomorphine and its assessment in 'off'-periods. The study was designed as five n = 1 studies, in which every patient was his own control. The effect of apomorphine was studied by using the Columbia rating scale and quantitative assessments, using tapping, walking and pinboard. There was a significant positive effect of apomorphine, in a mean optimal dose of 2.7 mg, with a mean latency of onset of 7.3 min and a mean duration of response of 96 min. After pretreatment with domperidone, no significant adverse effects were observed. Tapping showed the highest correlation with rigidity and bradykinesia. Walking showed a high correlation with stability and gait. Pinboard testing did not give additional information. The first conclusion was that apomorphine proved to be a significantly effective dopamine agonist, proven now also by a double blind placebo-controlled study. Secondly it was concluded that assessment of clinical effect in parkinsonian patients can be performed best by combining the Columbia item tremor with tapping and walking scores.
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The effect of domperidone, a peripheral dopamine receptor antagonist, has been studied in the aspirin, phenylbutazone and reserpine induced gastric ulcers in rats. The gastric anti-ulcer activity of domperidone was evident following a single dose as well as a 5-day pretreatment against all the three ulcerogenic drugs. However, the protection in the five-day pretreatment group was greater than in the single dose pretreatment group. It appears that the gastrokinetic properties of domperidone play a significant role in producing this anti-ulcer effect. The study substantiates the results of the clinical observations on the healing of gastric ulcers and provides a rationale for further clinical studies in that direction. The possible mechanisms of action of this agent are discussed.
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The incidence and consequences of the nausea and vomiting induced by many cancer chemotherapeutic regimes are explored and the emetogenic potential of the commonly used cytotoxic drugs evaluated. The physiology and pharmacology of chemotherapy-induced vomiting is largely unresolved but the postulated mechanisms are described and related to known properties of anti-emetic agents. The difficulties associated with the design and evaluation of trials assessing the effectiveness of single agent or combination therapy for this indication are discussed. After identifying general principles of anti-emetic prophylaxis, a critical evaluation is made of the effectiveness of the following drugs or classes of drugs, based on the available data: antihistamines, anticholinergics, phenothiazines, butyrophenones, domperidone, metoclopramide, cannabinoids, corticosteroids and benzodiazepines. Although there are still insufficient data to allow absolute recommendations to be made regarding the choice of anti-emetic therapy, considerations which should govern drug choice are listed and an algorithm presented as an aid to decision making. The contributions that can be made by a pharmacist in this area of drug use are noted.
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The effect of the intravenous administration of dihydroergotoxine (6 micrograms/kg) on arterial blood pressure, heart rate, and plasma concentrations of norepinephrine and 3,4-dihydroxyphenylacetic acid (the deaminated dopamine metabolite) was studied in 20 subjects with essential hypertension (8 men and 12 women aged 32-68 years old, World Health Organization Class I-II). In supine resting subjects, dihydroergotoxine significantly decreased systolic blood pressure (from 175 +/- 5 to 156 +/- 4 mm Hg; p less than 0.001), diastolic blood pressure (from 109 +/- 4 to 95 +/- 3 mm Hg; p less than 0.001), and heart rate (from 71 +/- 2 to 63 +/- 2 beats/min; p less than 0.001) as compared with the results of placebo treatment. Moreover, dihydroergotoxine reduced plasma levels of norepinephrine (from 368 +/- 39 to 238 +/- 33 pg/ml; p less than 0.001) and 3,4-dihydroxyphenylacetic acid (from 1.57 +/- 0.21 to 1.22 +/- 0.13 ng/ml; p less than 0.01). The time course of the blood pressure decrease paralleled that of plasma norepinephrine concentration. Dihydroergotoxine did not suppress the cardiovascular and plasma norepinephrine concentration. Dihydroergotoxine did not suppress the cardiovascular and plasma norepinephrine response to standing. The effect of domperidone, a peripheral presynaptic dopamine receptor antagonist, on dihydroergotoxine response was studied in six of the 20 subjects (3 men and 3 women 48-64 years old). The intravenous administration of domperidone (0.3 mg/kg) prevented the dihydroergotoxine-induced reduction in blood pressure and heart rate and the fall in plasma norepinephrine and 3,4-dihydroxyphenylacetic acid levels. Domperidone administered alone failed to significantly modify any measured variables.(ABSTRACT TRUNCATED AT 250 WORDS)
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Natriuresis was studied during water immersion in eight normal subjects either in the absence or in the presence of dopamine blockade by domperidone. Creatinine clearance showed no significant changes; urine flow remained significantly above control values during water immersion, implying persistent suppression of antidiuretic hormone. The marked natriuresis seen during water immersion alone was significantly blunted (P less than 0.05) but not abolished during water immersion plus domperidone. Suppression of the renin-aldosterone system by water immersion alone was not significantly different from that obtained during water immersion plus dopamine blockade. On the contrary, plasma prolactin levels, previously suppressed during water immersion alone, were significantly stimulated during water immersion plus domperidone, thus indirectly suggesting a role of dopamine in mediating the blunted natriuresis seen during water immersion.
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Binding of dopamine receptor ligands to human D2 and D3 receptors was characterized in Chinese hamster ovary (CHO) cells using the dopamine D2 receptor antagonist [125I] iodosulpiride. Only limited binding selectivity was observed for known dopamine D2 receptor antagonists from a variety of chemical classes, which included haloperidol, chlorpromazine, sulpiride, pimozide and cis flupenthixol. The most selective compound from this group were (+)butaclamol and domperidone which showed 5-fold D3 selectivity. A number of high affinity dopamine receptor agonists, including apomorphine and bromocriptine, also failed to demonstrate selectivity. In contrast, the natural ligand dopamine and the efficacious synthetic agonists quinpirole, (+)4-propyl-9-hydroxynapthoxazine (PHNO), 2-amino-6,7-dihydroxy-1,2,3,4-tetrahydronaphthalene (6,7-ADTN), 7-OH DPAT and N-0434 showed marked apparent human dopamine D3 (hD3) receptor selectivity. In the aminotetralin series, this selectivity was observed preferentially with analogs of the 6,7-rotamer compared with compounds from the 5,6-rotamer series. Functional coupling of the hD3 receptor was investigated in a number of cell lines in which the hD3 receptor was stably expressed, including CHO cells, the neuroblastoma-glioma hybrid cell line NG108-15 and a rat 1 fibroblast cell line. There was no evidence of functional coupling of the hD3 receptor to adenylate cyclase, arachidonic acid release, phospholipase C activation, K+ currents or calcium mobilization in any of the cell lines examined. Furthermore, guanine nucleotides failed to inhibit the binding of [3H] N-0437 to hD3 receptors in any of the three cell lines. There may be a number of explanations for these results. These cell lines may not have the appropriate G-protein or secondary messenger systems that are coupled to the hD3 receptor in situ. Alternatively, this receptor may couple by a mechanism that is as yet undefined. The finding that a wide range of structurally diverse human dopamine D2 (hD2) receptor agonists have an apparent hD3 selectivity may imply that the hD3 receptor exists predominantly in a high affinity state.
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This interaction may have clinical significance when domperidone is co-administered with rifampicin in chronic treatment conditions, such as tuberculosis, leprosy and other infections of joints, bones, etc.
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The interactions of dopaminergic agonists and antagonists with 3H-antagonist labeled D1 dopamine receptors of rat striatum have been characterized. [3H]Flupentixol has been found to selectively label D1 dopamine receptors when its binding to D2 dopamine receptors is blocked by the inclusion of D2 selective concentrations of unlabeled spiroperidol or domperidone. Antagonist/3H-antagonist competition curves are of uniformly steep slope (nH = 1.0) suggesting the presence of a single D1 dopamine receptor. Agonist/3H-antagonist competition curves are extremely shallow (nH less than or equal to 0.5) for agonists of high relative efficacy, suggesting the presence of heterogeneous populations of agonist-binding states of the D1 dopamine receptor. Computer-modeling techniques were used to estimate affinities and relative site densities for these heterogeneous binding states. This analysis indicates that the ratio of agonist affinities for low and high affinity agonist-binding states is correlated with agonist relative efficacies in activating adenylate cyclase in membrane homogenates. Under the assay conditions employed, the addition of saturating concentrations of guanine nucleotides reduced, but did not abolish, the relative density of high affinity agonist-binding sites. These binding data can, at least in part, be explained by postulating two states of the D1 dopamine receptor, inducible by agonists but not by antagonists and modulated by guanine nucleotides.
The rats that were subjected to short-term hyperprolactinemia exhibited a decrease in leukocyte counts in bronchoalveolar lavage, cellularity decrease in femoral marrow lavage fluid, a lower percentage of mucus, and an increase in lung IL-4, IL-6, IL-10, TNF-α and IFN-γ expression.
Male rats showed maternal behaviour within 72 h after the onset of continuous exposure to newborn rat pups. The latency of the behavioural response could be reduced by daily treatment with the dopamine receptor antagonist domperidone (2 X 2.5 mg/rat), which increased serum prolactin concentrations (241.4 +/- 26.5 (S.E.M.) micrograms/l) above those of vehicle-treated males exposed to pups (25.3 +/- 11.7 micrograms/l). Male rats did not respond to exposure to pups by secreting prolactin; keeping endogenous prolactin concentrations at a minimum (2.8 +/- 0.1 micrograms/l) by daily treatment with the dopamine receptor agonist bromocriptine (0.5 mg/rat) did not affect the behavioural response of male rats to newborn pups. Neither exposure to pups nor the modest hyperprolactinaemia induced by daily domperidone treatment affected the display of male sexual behaviour by male rats.
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The efficiency of Ovaprim™ salmon gonadotropin-releasing hormone agonist (GnRHa) and dopamine antagonist on the induction of spawning and spermiation in Prochilodus lineatus in comparison with the commonly used method using pituitary extract (PE) was evaluated. Females received PE at 0.5 + 5.0 mg/kg and Ovaprim™ at 0.05 + 0.45 ml/kg or at 0.125 + 0.375 ml/kg. All males received a first dose of PE at 0.4 mg/kg and then PE at 4.0 mg/kg or Ovaprim™ at 0.25 ml/kg. Oocyte, egg, larvae and sperm quality were evaluated. All females spawned and oocyte, egg and larvae quality were similar between Ovaprim™-treated (both doses) and PE-treated females. Data from females were pooled and the mean values were: 242 g ova weight, 15% ova index, 1209 oocytes/g ova, 284,539 oocytes/female, 183 oocytes/g body weight, 1.18 mm oocyte diameter, 49% fertilization rate, 43% hatching rate and 89% normal larvae. Sperm quality was similar between Ovaprim™-treated and PE-treated males. Data from males were pooled and the mean values of semen were: volume of 3.0 ml, 14.9 × 109 sperm/ml, osmolality of 283 mOsm/kg, pH of 7.4, 71% motile sperm, 217 μm/s curvilinear velocity, 102 μm/s straight-line velocity and 189 μm/s average path velocity. Ovaprim™ treatment can be used for commercial reproduction of P. lineatus, without any loss of gamete quality in comparison with PE treatment.
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The effects of noradrenaline, dopamine and 5-hydroxytryptamine were investigated on the duration of the action potential of embryonic chick sensory neurones in vitro. All three amines, like gamma-aminobutyric acid, decreased the duration of the action potential evoked by current injection. The onset of the noradrenaline-induced decrease in action potential duration was fast (less than 1s) and the recovery phase was dependent upon the dose of noradrenaline applied. Rapid washout of the noradrenaline revealed a minimum 30s recovery time which was independent of the initial noradrenaline concentration. Dopamine and 5-hydroxytryptamine could mimic the effects of noradrenaline on action potential duration. The ED50 for all three amines was approximately 1 microM. At a saturating concentration of 10 microM, noradrenaline was more potent than dopamine and 5-hydroxytryptamine. Saturating doses of noradrenaline and dopamine or 5-hydroxytryptamine were not additive. Responses to all three amines were affected similarly by antagonists: they were antagonized by yohimbine, phentolamine, haloperidol and mianserin but not by propranolol, prazosin, domperidone, spiperone or methysergide. Clonidine and xylazine (alpha 2-adrenoceptor agonists) were also without effect. In contrast to the amines, saturating concentrations of gamma-aminobutyric acid were additive with those of noradrenaline. Responses to GABA were not antagonized by the amine receptor antagonists. The evidence described here suggests that the amines and gamma-aminobutyric acid acid decrease sensory neurone action potential duration via pharmacologically-distinct membrane receptors. In addition, it is likely that the amines are acting via a single class of receptor whose pharmacology is different from classical adrenoceptors, dopamine receptors and 5-hydroxytryptamine receptors.
Periodic breathing (PB) is an instability of the respiratory control system believed to be mediated principally by the peripheral chemoreceptors. We hypothesised that domperidone, a dopamine D(2)-receptor antagonist that increases carotid body sensitivity to O(2) and CO(2), would promote PB through an increase in the loop gain (LG) of the respiratory control system. Domperidone significantly increased controller gain for oxygen (p<0.05) and gave rise, following post-hyperventilation apnea, to an increased incidence of PB (14% vs. 86%), an increased PB epoch duration, and a decrease in duty ratio of PB (p<0.001); these changes are consistent with domperidone increasing LG. Although domperidone increased controller gain for CO(2) (p<0.05), the contribution of Pa(CO)(2) oscillations to the genesis of PB in the lamb remained small. We conclude that domperidone increases LG in the lamb via an increase in controller gain for oxygen. Our study demonstrates that a quantitative understanding of the factors that determine LG provides insight into the cause of PB.
Gastroparesis is a disorder of gastric motility that results in delayed gastric emptying. Common symptoms include early satiety, postprandial fullness, epigastric pain, nausea, vomiting, and weight loss. The underlying etiologies of gastroparesis are many and include diabetes, prior gastric surgery, collagen vascular disorders, and a previous viral illness. Up to one third of cases are classified as idiopathic. Treatment typically consists of a change in diet to small volume, frequent meals and the use of the prokinetic agents metoclopramide, cisapride, erythromycin, or domperidone. Botulinum toxin has recently been shown to be effective in treating disorders of smooth muscle hypertonicity in the GI tract. This case report describes three patients with severe gastroparesis whose symptoms persisted despite dietary changes and the use of high dose prokinetic agents. All three were treated with intrasphincteric injection of the pylorus with botulinum toxin and all had significant symptomatic improvement afterwards. Possible mechanisms of action of botulinum toxin on the pylorus and its effects in patients with gastroparesis are discussed.
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Domperidone (prokinetic agent) is frequently co-administered with pioglitazone (anitidiabetic) or ondansetron (antiemetic) in gastroparesis management. These drugs are metabolized via cytochome P-450 (CYP) 3A4, raising the possibility of interaction and adverse reactions. The concentration-dependent inhibitory effect of pioglitazone and ondansetron on domperidone hydroxylation was monitored in pooled human liver microsomes (HLM). Pioglitazone was further assessed as a mechanism-based inhibitor. Microsomal binding was evaluated in our assessment. In HLM, Vmax/Km estimates for monohydroxy domperidone formation decreased in presence of pioglitazone. Diagnostic plots indicated that pioglitazone inhibited domperidone in a partial mixed-type manner. The in vitro Ki was 1.52 µM. Predicted in vivo AUCi/AUC ratio was 1.98. Pioglitazone also exerted time-dependent inhibition on the metabolism of domperidone and the average remaining enzymatic activity decreased significantly upon preincubation with pioglitazone over 0-40 min. Diagnostic plots showed no inhibitory effect of ondansetron on domperidone hydroxylation. 6. In conclusion, pioglitazone inhibited domperidone metabolism in vitro through different complex mechanisms. Our in vitro data predict that the co-administration of these drugs can potentially trigger an in vivo drug-drug interaction.
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To assess the effect of medication given for at least seven days to mothers of preterm infants whose breastmilk is insufficient for their infants' needs on the outcomes of expressed milk volume and duration of breastfeeding.
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Apomorphine antagonistic effects of a range of dopamine (DA) antagonists were studied after intracerebral and after peripheral injection. Inhibitory activity was found selectively within the ventral striatum with a D-1 antagonist (SCH 23390), D-2 antagonists (benzamides, butyrophenones) and mixed D-1/D-2 antagonists (thioxanthenes, phenothiazines), whereas alpha-adrenoceptor antagonists, muscarinic- and serotonin S2-antagonists were ineffective. Great differences in absolute potencies and in peripheral versus intrastriatal potency ratios were observed. High peripheral versus central selectivity ratios and high intrastriatal potencies were found with the hydrophilic compounds (-)-sulpiride, veralipride and domperidone which do not readily cross the blood-brain barrier. High intrastriatal potency was also observed for the benzamide, YM 09151-2, haloperidol and spiroperidol although these compounds had lower peripheral versus intrastriatal selectivity ratios. Neuroleptic potency after intracerebral administration did not depend solely on DA receptor affinity but additionally on physicochemical properties. On the basis of the peripheral vs. intrastriatal potency ratios, it is concluded that only few of the neuroleptics tested in this study are suited for topographical studies of DA receptor function using intracerebral injection but that (-)-sulpiride is one example combining high potency, high central selectivity, high DA D-2 receptor specificity, stereoselectivity and long duration of action. The site-selectivity of apomorphine-antagonistic effects was further studied using (-)-sulpiride as a model compound. Inhibitory activity against oral stereotypy was preferentially found after injection into the ventral striatum, whereas the low-component patterns of apomorphine stereotypy (sniffing, rearing, motility) were blocked equally well in the ventral striatum and nucleus accumbens.(ABSTRACT TRUNCATED AT 250 WORDS)
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Obstructive sleep apnea; oximetry; sleepiness; domperidone; pseudoephedrine; pharmacotherapy; desaturation; treatment