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Value of esophageal pharmacomanometry (EPM) for evaluation of drug effects in man

  • Part III: Drug Effects on Esophageal Smooth Muscle
  • Published:
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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.

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Authors and Affiliations

  1. Department of Medicine and Development, Pharmaceutical Research Center, Bayer AG, 5600, Wuppertal 1, Germany

    T. R. Weihrauch MD & A. R. Baunack MD

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  1. T. R. Weihrauch MD
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  2. A. R. Baunack MD
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Weihrauch, T.R., Baunack, A.R. Value of esophageal pharmacomanometry (EPM) for evaluation of drug effects in man. Digest Dis Sci 36, 62S–65S (1991). https://doi.org/10.1007/BF01300598

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  • DOI: https://doi.org/10.1007/BF01300598

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