ABSTRACT
Treatment of alcoholics with phenytoin and disulfiram (DI) simultaneously is complicated and inexpedient because of the marked drug interaction. The aim of this study was to investigate whether an interaction exists between DI and carbamazepine (CBZ). The serum levels of CBZ and the metabolite CBZ-10, 11-epoxide were measured by high-pressure liquid chromatography in seven out-patients with epilepsy, on monotherapy with CBZ, before and during two weeks administration of DI. Five patients completed the investigation. None were alcoholics. The changes in the serum levels were insignificant, i.e. without clinical important. Moreover, uncontrolled clinical experience has not indicated any interaction between DI and CBZ. Thus the influence of DI on the metabolism of CBZ is probably negligible. CBZ is suggested, therefore, when anticonvulsive therapy is needed by alcoholics in treatment with DI.
Subject(s)
Carbamazepine/administration & dosage , Disulfiram/administration & dosage , Epilepsy/drug therapy , Adult , Carbamazepine/analogs & derivatives , Carbamazepine/blood , Drug Interactions , Epilepsy/blood , Female , Humans , Male , Middle AgedABSTRACT
59 outpatients with irritable bowel syndrome participated in a randomised double-blind trial. The patients in the treatment group received three biscuits daily each containing 10 g of ordinary miller's bran, whereas the patients in the control group received wheat biscuits of a similar appearance. The treatment period was 6 weeks. 52% of the patients in the treatment group noted subjective improvement compared with 65% in the control group. The results of this trial do not support the routine use of miller's bran in irritable bowel syndrome.
Subject(s)
Colonic Diseases, Functional/diet therapy , Triticum , Adolescent , Adult , Aged , Clinical Trials as Topic , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Male , Middle Aged , Placebos , Time FactorsABSTRACT
Bile acid absorption was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). By computerizing absorption kinetics the presence of an active transport of glycochenodeoxycholic acid (GCDC) was rendered probable by finding a saturable transport system and a competitive absorption between conjugated bile acids. At the time of investigation 5 patients had no diarrhoea, whereas 6 patients had diarrhoea as defined from the amount of faecal output. In the former group the faecal bile acid excretion was low, the ileal absorption of GCDC high, and judged from the xylose absorption the ileal absorption surface large compared to the latter group, in which the faecal bile acid excretion was high, the ileal absorption of GCDC low, and the ileal absorptive surface small. It is concluded that malabsorption of bile acids in the ileum may be of significant physiological importance in the pathogenesis of diarrhoea in patients with regional ileitis.
Subject(s)
Bile Acids and Salts/metabolism , Crohn Disease/metabolism , Ileum/metabolism , Intestinal Absorption , Adult , Biological Transport, Active , Crohn Disease/complications , Diarrhea/complications , Diarrhea/metabolism , Female , Glycocholic Acid/metabolism , Humans , Kinetics , Male , Middle Aged , PerfusionABSTRACT
Electrolyte and water movement was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). Six patients who at the time of investigation had diarrhoea showed a constant secretion of salts and fluid during perfusion with control perfusate. Per 24 hours, the ileal effluents to colon would exceed the normal amount by 1-2 litres. In the 5 patients without diarrhoea the absorption patterns were normal. Electrolytes and water moved in parallel. Dihydroxy bile acids enhanced secretion or decreased absorption respectively, in the two groups of patients. It is concluded that functional disturbances of salt and water absorption in the inflamed ileum may be of significant physiological importance in the pathogenesis of diarrhoea observed in patients with regional ileitis.
Subject(s)
Bile Acids and Salts/pharmacology , Crohn Disease/metabolism , Ileum/metabolism , Water-Electrolyte Balance/drug effects , Adult , Bile Acids and Salts/metabolism , Crohn Disease/complications , Diarrhea/complications , Diarrhea/metabolism , Female , Glucose/metabolism , Humans , Intestinal Absorption , Male , Middle Aged , Perfusion , Xylose/metabolismABSTRACT
Polyethylene glycol 4000 (PEG plus 3H-PEG) was used as volume indicator during ileal perfusion in man. Faeces, urine, ileal infusates, and aspirates were investigated. Turbidimetrical assay and liquid scintillation counting (in the faeces radioassay was done after conbustion) yielded similar estimates of water absorption and secretion. Tracer amounts of 3H were found in the urine, indicating a minimal absorption. The simplicity of 3H radioassay and the reliability of 3H-PEG as a non-absorbable water phase marker is emphasized.
