Oral anticholinergics and gastric emptying

Area of Science:

• Pharmacology
• Gastroenterology
• Drug Metabolism

Background:

• Quaternary ammonium antimuscarinic drugs are used for various conditions.
• Their effect on gastric emptying requires further elucidation.
• Propantheline bromide and clidinium bromide are common examples.

Purpose of the Study:

• To investigate the impact of propantheline bromide and clidinium bromide on gastric emptying.
• To determine if the route of drug administration affects gastric emptying.
• To compare the effects of clidinium bromide and propantheline bromide on gastric emptying and salivary secretion.

Main Methods:

• A radiolabeled liquid meal was administered orally and via gastric tube to human subjects.
• Gastric emptying was measured using a gamma camera.
• Subjects received varying doses of propantheline bromide and clidinium bromide, or placebo.

Main Results:

• Oral administration of propantheline bromide and clidinium bromide dose-dependently delayed gastric emptying.
• Gastric intubation alone could slow gastric emptying in some individuals.
• Propantheline bromide at 30 mg slowed emptying in some subjects receiving intubated meals, while others showed paradoxical acceleration.
• Clidinium bromide (5 mg) delayed gastric emptying similarly to propantheline bromide (15 mg) but with less salivary suppression.

Conclusions:

• Oral quaternary ammonium antimuscarinic drugs significantly delay gastric emptying in a dose-dependent manner.
• The method of drug and meal administration influences gastric emptying.
• Clidinium bromide offers a potential alternative for delaying gastric emptying with reduced impact on salivary secretion compared to propantheline bromide.