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  • 1
    Electronic Resource
    Electronic Resource
    Effect of the calcium antagonists nifedipine, nitrendipine, nimodipine and nisoldipine on oesophageal motility in man (1991)
    Springer
    European journal of clinical pharmacology 41 (1991), S. 313-316 
    Details
    ISSN: 1432-1041
    Keywords: Calciumantagonists ; Oesophageal motility ; oesophageal pharmaco-manometry ; lower oesophageal sphincter pressure ; healthy volunteers ; dihydropyridines ; nifedipine ; nifedipine ; nisoldipine ; nitrendipine ; nimodipine ; side ; effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Nifedipine has been proven to be effective and safe in the treatment of primary oesophageal motility disorders which can cause angina-like chest pain and/or dysphagia. The effects of the calcium channel blockers nifedipine, nitrendipine, nimodipine and nisoldipine on oesophageal smooth muscle function in healthy male volunteers were studied by oesophageal manometry using the rapid pull-through-technique, in two randomized, double-blind crossover studies. Lower oesophageal sphincter pressure, oesophageal contraction amplitude and duration after a wet swallow (measured 5 cm and 10 cm above the lower oesophageal sphincter) were determined 30 min before and at 10 minute intervals up to 90 min after the administration of nimodipine and up to 120 min after nifedipine, nitrendipine and nisoldipine. The plasma drug concentration was measured at baseline (−15 min) and in parallel with the manometric measurements. Compared to placebo, lower oesophageal sphincter pressure was significantly decreased by 24% by nifedipine and 17% by nimodipine, whereas the effects of nitrendipine (decrease of 15%) and nisoldipine (9%) were not significant. Nifedipine significantly decreased by 17% the oral contraction amplitude compared to placebo and nimodipine by 11%. The duration of the contraction amplitudes was not altered. The decrease in sphincter pressure was correlated with the corresponding plasma drug levels of nifedipine r=0.92, nitrendipine r=0.80 and nisoldipine r=0.79. Nimodipine showed no such correlation. It is concluded that among the calcium antagonists studied, nifedipine exerted the strongest effect on oesophageal smooth muscle function, so it appears to be the most suitable compound for the treatment of primary motor abnormalities of the oesophagus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314958
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Value of esophageal pharmacomanometry (EPM) for evaluation of drug effects in man (1991)
    Springer
    Digestive diseases and sciences 36 (1991), S. 62S 
    Details
    ISSN: 1573-2568
    Keywords: esophageal pharmacomanometry ; dose-response relationship ; motility disorders ; drug safety
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Esophageal pharmacomanometry (EPM) has become an established procedure for drug evaluation in man. With this method the effect of drugs on smooth muscle in man can be directly investigated. Methods for pressure recording have achieved sufficient accuracy to yield reliable and reproducible results. The procedure is technically easy to perform, is well tolerated, and is safe—so far no serious side effects have been reported. Standard protocols for examination, which have been confirmed by different investigators, have become available. The value of EPM in clinical pharmacology and in clinical medicine can be categorized as follows: Assessment of (1) efficacy of drugs in esophageal motility disorders (prokinetic/spasmolytic compounds); (2) safety of drugs used for other diseases (analysis whether motility is negatively affected, eg, with β2-agonists, calcium antagonists, PGE1 and PGE2 derivatives); (3) differential diagnosis using different drugs in suspected disease; (4) efficacy of anesthesia during operations and of sedation in the critically ill in the intensive care unit (drug monitoring); and (5) pathophysiologic questions using the drug as a tool (eg, metoclopramide in reflux esophagitis). It is important to realize that all drugs used therapeutically in esophageal motility disorders also show an effect in healthy volunteers measurable by esophageal manometry. However, therapeutic studies are ultimately necessary to determine the optimal dose regimen in patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01300598
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Influence of migrating motor complex on esophageal motility (1991)
    Springer
    Digestive diseases and sciences 36 (1991), S. 78S 
    Details
    ISSN: 1573-2568
    Keywords: esophageal pharmacomanometry ; lower esophageal sphincter pressure ; migrating motor complex ; measurement methods ; humans
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In most fasting mammals motility of the foregut and small intestine undergoes regular cycles of activity. The phenomenon has been called the interdigestive migrating myoelectric complex or the migrating motor complex. As shown in published literature, feeding interrupts the cycle and changes the interdigestive fasted pattern into a pattern of irregular spiking activity, which has been called the fed pattern. The mapping of the migrating motor complex throughout the upper gut demonstrated major regional variations. The incidence of migrating motor complex at multiple sites from distal esophagus to cecum approximated a normal distribution. In the course of esophageal manometric studies the influence of migrating motor complex on lower esophageal sphincter was observed. This observation raised the question whether future pharmacomanometric studies should be performed with volunteers in the fasting state as done until now. According to published literature, lower esophageal sphincter pressure is significantly higher during migrating motor complex phase III than phase I; differences are approximately twofold. Fifty percent of migrating motor complexes involve the esophagus. The migrating motor complex in some individuals interferes significantly with esophageal pharmacomanometry provided the volunteers are fasted. On the other hand postprandial lower esophageal sphincter pressure was rather constant at a level comparable with that measured in migrating motor complex phase I. The consequences of this phenomenon for the study design in pharmacomanometry are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01300600
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    Paper (German National Licenses)
    Fulltext
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