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- Title
Do Muscarinic Receptors Play a Role in Acute Pancreatitis?: A Randomised Comparison of Pirenzepine and Nasogastric Suction.
- Authors
Zapater, P.; Abad-Santos, F.; Alcalde-Rubio, M.; Moreno-Otero, R.
- Abstract
Objective: In a previous clinical trial, we reported the potential usefulness of pirenzepine, a selective muscarinic M cholinergic receptor antagonist, in the treatment of acute pancreatitis. The aim of this study is to extend these results to determine the comparative efficacy and tolerability of pirenzepine and nasogastric suction in the treatment of acute pancreatitis. Design: Prospective, randomised, comparative clinical trial. Setting: University hospital. Patients: 50 consecutive patients admitted to the emergency room with acute pancreatitis diagnosed by abdominal pain and serum amylase levels higher than 700 IU/L or urine amylase levels higher than 1800 IU/L. Interventions: Patients received treatment with nasogastric suction or pirenzepine (10mg every 12 hours intravenously followed by 50mg every 12 hours orally once oral intake had resumed). Main Outcome Measures: Serum and urine amylase levels and clinical symptoms. Results: Basal clinical and biochemical parameters were similar between the two treatment groups. Pirenzepine significantly decreased the duration of hyperamylasaemia and hyperamylasuria, and the time to resumption of bowel sounds, passage of first faeces and clinical recovery compared with nasogastric suction. Pirenzepine was well tolerated and there were no differences between the two groups in the incidence of complications associated with acute pancreatitis. Conclusions: The use of pirenzepine in acute pancreatitis has proved to be more beneficial in shortening the recovery period than nasogastric suction and thus may be a more beneficial alternative in these patients. The results of this trial reinforce our thinking that selective muscarinic M-receptor antagonists warrant evaluation in further studies to define their efficacy and tolerability in patients with acute pancreatitis.
- Subjects
PIRENZEPINE; PANCREATITIS treatment
- Publication
Clinical Drug Investigation, 2000, Vol 20, Issue 6, p401
- ISSN
1173-2563
- Publication type
Article
- DOI
10.2165/00044011-200020060-00002