Gastrointestinal response to minute doses of glucagon.

Small doses of glucagon are effective when performing a biphasic gastrointestinal (GI) examination. The authors conducted a controlled double-blind crossover study to determine the optimum and smallest effective doses and the onset and duration of drug action. Fifteen men received a placebo and 0.025, 0.05, 0.1, and 0.2 mg of glucagon intravenously. Hypotonicity of the stomach, duodenum, and small bowel was adequate with 0.1 mg of glucagon. Low-dose glucagon makes the biphasic upper GI examination short and practical. There is no need to delay the second phase of the examination or the small-bowel follow-through.

Effect of D-Val1, D-Trp8-somatostatin on the motility of the stomach, duodenum and jejunum.

D-Val1, D-Trp8-somatostatin was given to seven volunteers to relax the gastrointestinal tract. Doses of drug ranging from 1-250 mcg. were given intravenously, single blind, as one bolus. The seven subjects had a total of 23 studies. The stomach never became hypotonic in any subject. The onset of drug effect on the duodenum and jejunum of moderate hypotonicity after 10-100 mcg. was 4.8 minutes and at 150-250 mcg., was 10.1 minutes. Onset of atonicity after 10-100 mcg. wa 5.7 minutes and at 150-2509 mcg., was 13.0 minutes. Duration of moderate hypotonicity after 10-100 mcg. was 20.9 minutes and at 150-250 mcg., was 22.4 minutes. Duration of atonicity at 10-100 mcg. was 11.5 minutes and at 50-250 mcg., was 14.1 minutes. Preliminary results suggest that the onset and duration of effect, relative to dose, were so variable that the drug appeared to be an unsatisfactory hypotonic agent for upper gastrointestinal radiography.

Comparison of gastrointestinal effects of aspirin and fenoprofen. A double blind crossover study.

Sixteen men received 3904 mg of aspirin, 2400 mg of fenoprofen, or placebo daily for 1 week in a double blind and crossover trial. Fecal blood loss was measured by 51Cr labeled red cells; gastric and duodenal pathology were observed endoscopically. There was more (P less than 0.05) blood loss (4.96 ml) after aspirin than after fenoprofen (2.46 ml) or placebo (0.79 ml). By endoscopic examination, aspirin induced more (P less than 0.05) gastrointestinal pathology than fenoprofen or placebo, and there was a correlation of 0.70 between the two methods used in this study.

Comparison of the effects of glucagon and atropine sulfate on gastric emptying.

Six asymptomatic adult males cooperated in a study of gastric emptying. Each subject was given a test meal of 500 ml. of 3.5% glucose on a fasting stomach. Ten minutes prior to the meal each was given either 1 mg atropine sulfate, placebo, or 2 mg. glucagon, double-blind and crossover. Each drug was given twice, intravenously, in a random order. The meal was removed by a Salem sump tube half an hour after ingestion. When compared to placebo, the active drugs significantly (P less than 0.05) slowed gastric emptying; atropine sulfate was more effective (P less than 0.05) than glucagon. The active drugs significantly (P 0.05) decreased total gastric acid secretion and total gastric chloride as compared to placebo. Glucagon significantly (P 0.05) increased the blood glucose concentration as compared to placebo. These results indicate that both glucagon and atropine sulfate slow the gastric emptying of a liquid sugar meal from the stomach.

Dose response to intramuscular glucagon during hypotonic radiography.

In a study to determine a dose response to glucagon during hypotonic duodenography, 15 male and female volunteers received placebo and 0.25 mg 1 mg and 2 mg glucagon intramuscularly, double-blind and cross-over. When 0.25 mg glucagon was given, the onset of drug effect was approximately 13--18 min: the mean duration of moderate hypotonicity was approximately 4--7 min. The larger the dose, the greater the duration of drug action. When 2 mg glucagon was given, the onset of drug effect occurred in approximately 4--7 min; the mean duration of moderate hypotonicity was 22--32 min. There were no changes in pulse or blood pressure attributable to the drug with these doses, and reports of nausea and diarrhea did not increase significantly until a dose above 1 mg was given. One mg glucagon given IM is useful in hypotonic upper Gl radiographic examinations. The onset of hypotonicity was 8--10 min with a duration of 12--27 min when this dose was given. Few reports of side effects were attributable to this dose.

Double-blind radiographic study of dose response to intravenous glucagon for hypotonic duodenography.

This study was undertaken to determine a dose response to glucagon during hypotonic duodenography. Fifteen male and female volunteers received placebo and 0.25 mg, 0.5 mg, 1 mg, and 2 mg of glucagon intravenously, double-blind, and crossover. Onset of drug effect occurred in approximately 45 seconds, regardless of the dose of glucagon given. There was a significant (p less than 0.01) decrease in gastrointestinal tonicity with all doses. The larger the dose, the greater the duration of drug action. Satisfactory stomach, duodenal, and small bowel hypotonicity for radiography were obtained with 0.25 to 0.5 mg of glucagon given intravenously with few side effects.

Response of normal subjects to a single 2-milligram dose of glucagon administered intramuscularly.

Recently there has been increased interest in glucagon because in human radiographic and endoscopic studies it has been reported to relax the gallbladder, stomach, small bowel and colon. These results suggest it may be preferable as a diagnostic aid for these procedures. Therefore, we believed it important to assess the safety, and clinical laboratory responses after glucagon is given to normal subjects. Twenty normal subjects received 2 mg of glucagon and placebo intramuscularly at daily intervals, double-blind and crossover. After glucagon there was an increase in the WBC, bands, neutrophiles, fasting blood sugar, glucagon and insulin, and a decrease in the lymphocytes. There was no change in the pulse rate or blood pressure with minimal reports of side effects. These results tend to confirm other reports that glucagon is one of the stress hormones. Glucagon is remarkably safe and produces few, mild and transient side effects, not much greater than placebo.