[Etiology, pathogenesis and treatment of gastroparesis].
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Biomedical subjects
Publications and source records attributed to I V Markovskaia.
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Monkey and dog sensitivity to the emetics that stimulate catecholamino- and serotoninoreactive structures of the chemoreceptor trigger zone (CTZ) of the vomiting center has been studied. It has been found that the monkeys are sensitive to the vomiting effect of serotonin agonists, while the dogs to the stimulants of the dopamino- and adrenoreceptors of the CTZ. At the same time both the monkeys and dogs are equally sensitive to the emetic action of sodium salicylate. The latter's effect has been shown to be realized via the serotoninergic structures of the CTZ in the monkeys, and via the adrenergic structures in the dogs. It is suggested that specific features of the monkey and dog responses to administration of central emetics are determined by the differences in the neurochemical structure of the CTZ, particularly by the prevalence of the serotonin- or catecholamine-containing neurons.
In experiments with rats exposed to 200 Gy radiation it was shown that the diarrhea effect of serotonin under the effect of radiation is implemented via D- and M-type receptors, and that of histamine via H1 and H2 receptors. Serotonin and histamine, that were released under the effect of radiation from endocrine and mast cells of the digestive tract, stimulated the propulsion activity of the intestine whereas histamine, in addition, inhibited the absorption process. It is suggested that serotonin and histamine antagonists should be used as means of preventing of radiation-induced diarrhea.
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In experiments with rats it was shown that pharmacological substances that deplete the biogenic amine pool or selectively arrest dopamine and serotonin receptors prevent or considerably reduce the postirradiation gastrostasis. It is suggested that activation of dopamine- and serotonergic inhibiting mechanisms of regulation of motor-evacuative function of the stomach is responsible for the postirradiation delay in gastric evacuation.
Dimetpramide, a new antiemetic drug (manufactured in the USSR) from the group of substituted benzamides, produced, due to blockade of catecholaminergic receptors, an increase in dopamine and noradrenaline turnover rates in the subcortical-brainstem regions responsible for the behavioural activity when administered at considerably higher doses than those of metoclopramide, a conventional drug of similar type. It is suggested that the probability of the occurrence of undesirable side effects of dimetpramide in clinical practice (extrapyramidal and sedative effects) would be much less than with metoclopramide.
In experiments on rats it was shown that after 20 Gy irradiation dopamine and homovanilic acid content increases in the caudate nucleus and limbic structures of the forebrain: dopamine disappears more readily when its biosynthesis is blocked. The rate of the mediator degradation in the brain increases by 1.5-2 times, and the rate of the synthesis, by 3-5 times at early times after irradiation.
Irradiation of rats with a dose of 20 Gy exerts a pronounced inhibitory action on the stimulation by phenamine of their behaviour activity. Since the ability of the preparation to increase the synthesis and release (degradation) of dopamine and norepinephrine does not change the effect of radiation it is suggested that under the action of radiation the sensitivity of catecholaminergic ceptors to the effect of the corresponding neuromediators decreases.
It has been shown that dimethpramide, a new Soviet-made antiemetic belonging to the group of substituted benzamides, effectively prevents the emetic action of L-DOPA and apomorphine in dogs (the ED50 is 0.04 and 0.12 mg/kg, respectively). When given in doses of 10-25 mg/kg dimethpramide suppresses vomiting induced by adrenaline, histamine, strophanthine, sodium salicylate, and copper sulfate. The drug exerts a selective dopamine-blocking action on the receptors of the triggering zone of the vomiting center without producing any substantial action on the dopaminergic brain systems that regulate behavioral activity.
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It has been shown in experiments on rats that preinjection into the animals of amphetamine, isoprenaline hydrochloride, clonidine and phentolamine activating adrenergic transmission increases the resistance to the convulsant action of corasole. Disulfiram and guanethidine that decrease the content of noradrenaline in the body facilitate the development of corasole convulsions. The agents that change functional activity of the dopaminergic synapses (L-DOPA, alpha-methyldopa, apomorphine, perphenazine hydrochloride) exert no substantial effect on the convulsant effect of corasole. It is suggested that alpha- and beta-adrenergic structures participate in the mechanisms of catecholaminergic regulation of convulsant activity.