Effect of glyceryl trinitrate on the sphincter of Oddi spasm evoked by prostigmine-morphine administration

Borbála Velosy, László Madácsy, J. Lonovics, L. Csernay

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: In this study the effect of glyceryl trinitrate on the prostigmine-morphine-induced sphincter of Oddi spasm was evaluated in nine female patients with sphincter of Oddi dyskinesia. Method: Sphincter of Oddi spasm was induced by prostigmine-morphine administration (0.5 mg prostigmine intramuscularly and 10 mg morphine subcutaneously) and visualized by quantitative hepatobiliary scintigraphy. The entire procedure was repeated during glyceryl trinitrate infusion (Nitrolingual 1 μg/kg/min for 120 min). Results: Prostigmine-morphine provocation caused significant increases in the time to peak activity (T(max)) over the hepatic hilum (HH: 34.33 ± 5.05 vs. 22.77 ± 3.26) and the common bile duct (CBD: 60.44 ± 5.99 vs. 40.0 ± 2.88) and in the half-time of excretion (T(max)) over the liver parenchyma (LP: 120.04 ± 16.01 vs. 27.37 ± 2.19), HH (117.61 ± 14.71 vs. 31.85 ± 3.99) and CBD (158.11 ± 9.18 vs. 40.1 ± 6.24), indicating a complete spasm at the level of the sphincter of Oddi. Glyceryl trinitrate infusion completely normalized the prostigmine-morphine-induced alterations in these quantitative parameters (T(max) over the LP: 11.33 ± 1.13; over the HH: 18.88 ± 1.48; and over the CBD: 36.22 ± 1.92; and T(1/2) over the LP: 28.21 ± 1.83; over the HH: 33.42 ± 3.10; and over the CBD: 41.66 ± 6.33), suggesting an effective sphincter-relaxing effect of glyceryl trinitrate. Conclusion: These results provide the first evidence of the effectiveness of glyceryl trinitrate on the morphine-induced sphincter of Oddi spasm in humans. Since glyceryl trinitrate is able to overcome even the drastic effect of morphine, it might be of relevance in the treatment of sphincter of Oddi dyskinesia.

Original languageEnglish
Pages (from-to)1109-1112
Number of pages4
JournalEuropean Journal of Gastroenterology and Hepatology
Volume9
Issue number11
Publication statusPublished - 1997

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Sphincter of Oddi
Neostigmine
Nitroglycerin
Spasm
Morphine
Sphincter of Oddi Dysfunction
Liver
Common Bile Duct
Radionuclide Imaging

Keywords

  • Glyceryl trinitrate
  • Prostigmine-morphine provocation
  • Sphincter of Oddi

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Effect of glyceryl trinitrate on the sphincter of Oddi spasm evoked by prostigmine-morphine administration. / Velosy, Borbála; Madácsy, László; Lonovics, J.; Csernay, L.

In: European Journal of Gastroenterology and Hepatology, Vol. 9, No. 11, 1997, p. 1109-1112.

Research output: Contribution to journalArticle

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abstract = "Objective: In this study the effect of glyceryl trinitrate on the prostigmine-morphine-induced sphincter of Oddi spasm was evaluated in nine female patients with sphincter of Oddi dyskinesia. Method: Sphincter of Oddi spasm was induced by prostigmine-morphine administration (0.5 mg prostigmine intramuscularly and 10 mg morphine subcutaneously) and visualized by quantitative hepatobiliary scintigraphy. The entire procedure was repeated during glyceryl trinitrate infusion (Nitrolingual 1 μg/kg/min for 120 min). Results: Prostigmine-morphine provocation caused significant increases in the time to peak activity (T(max)) over the hepatic hilum (HH: 34.33 ± 5.05 vs. 22.77 ± 3.26) and the common bile duct (CBD: 60.44 ± 5.99 vs. 40.0 ± 2.88) and in the half-time of excretion (T(max)) over the liver parenchyma (LP: 120.04 ± 16.01 vs. 27.37 ± 2.19), HH (117.61 ± 14.71 vs. 31.85 ± 3.99) and CBD (158.11 ± 9.18 vs. 40.1 ± 6.24), indicating a complete spasm at the level of the sphincter of Oddi. Glyceryl trinitrate infusion completely normalized the prostigmine-morphine-induced alterations in these quantitative parameters (T(max) over the LP: 11.33 ± 1.13; over the HH: 18.88 ± 1.48; and over the CBD: 36.22 ± 1.92; and T(1/2) over the LP: 28.21 ± 1.83; over the HH: 33.42 ± 3.10; and over the CBD: 41.66 ± 6.33), suggesting an effective sphincter-relaxing effect of glyceryl trinitrate. Conclusion: These results provide the first evidence of the effectiveness of glyceryl trinitrate on the morphine-induced sphincter of Oddi spasm in humans. Since glyceryl trinitrate is able to overcome even the drastic effect of morphine, it might be of relevance in the treatment of sphincter of Oddi dyskinesia.",
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T1 - Effect of glyceryl trinitrate on the sphincter of Oddi spasm evoked by prostigmine-morphine administration

AU - Velosy, Borbála

AU - Madácsy, László

AU - Lonovics, J.

AU - Csernay, L.

PY - 1997

Y1 - 1997

N2 - Objective: In this study the effect of glyceryl trinitrate on the prostigmine-morphine-induced sphincter of Oddi spasm was evaluated in nine female patients with sphincter of Oddi dyskinesia. Method: Sphincter of Oddi spasm was induced by prostigmine-morphine administration (0.5 mg prostigmine intramuscularly and 10 mg morphine subcutaneously) and visualized by quantitative hepatobiliary scintigraphy. The entire procedure was repeated during glyceryl trinitrate infusion (Nitrolingual 1 μg/kg/min for 120 min). Results: Prostigmine-morphine provocation caused significant increases in the time to peak activity (T(max)) over the hepatic hilum (HH: 34.33 ± 5.05 vs. 22.77 ± 3.26) and the common bile duct (CBD: 60.44 ± 5.99 vs. 40.0 ± 2.88) and in the half-time of excretion (T(max)) over the liver parenchyma (LP: 120.04 ± 16.01 vs. 27.37 ± 2.19), HH (117.61 ± 14.71 vs. 31.85 ± 3.99) and CBD (158.11 ± 9.18 vs. 40.1 ± 6.24), indicating a complete spasm at the level of the sphincter of Oddi. Glyceryl trinitrate infusion completely normalized the prostigmine-morphine-induced alterations in these quantitative parameters (T(max) over the LP: 11.33 ± 1.13; over the HH: 18.88 ± 1.48; and over the CBD: 36.22 ± 1.92; and T(1/2) over the LP: 28.21 ± 1.83; over the HH: 33.42 ± 3.10; and over the CBD: 41.66 ± 6.33), suggesting an effective sphincter-relaxing effect of glyceryl trinitrate. Conclusion: These results provide the first evidence of the effectiveness of glyceryl trinitrate on the morphine-induced sphincter of Oddi spasm in humans. Since glyceryl trinitrate is able to overcome even the drastic effect of morphine, it might be of relevance in the treatment of sphincter of Oddi dyskinesia.

AB - Objective: In this study the effect of glyceryl trinitrate on the prostigmine-morphine-induced sphincter of Oddi spasm was evaluated in nine female patients with sphincter of Oddi dyskinesia. Method: Sphincter of Oddi spasm was induced by prostigmine-morphine administration (0.5 mg prostigmine intramuscularly and 10 mg morphine subcutaneously) and visualized by quantitative hepatobiliary scintigraphy. The entire procedure was repeated during glyceryl trinitrate infusion (Nitrolingual 1 μg/kg/min for 120 min). Results: Prostigmine-morphine provocation caused significant increases in the time to peak activity (T(max)) over the hepatic hilum (HH: 34.33 ± 5.05 vs. 22.77 ± 3.26) and the common bile duct (CBD: 60.44 ± 5.99 vs. 40.0 ± 2.88) and in the half-time of excretion (T(max)) over the liver parenchyma (LP: 120.04 ± 16.01 vs. 27.37 ± 2.19), HH (117.61 ± 14.71 vs. 31.85 ± 3.99) and CBD (158.11 ± 9.18 vs. 40.1 ± 6.24), indicating a complete spasm at the level of the sphincter of Oddi. Glyceryl trinitrate infusion completely normalized the prostigmine-morphine-induced alterations in these quantitative parameters (T(max) over the LP: 11.33 ± 1.13; over the HH: 18.88 ± 1.48; and over the CBD: 36.22 ± 1.92; and T(1/2) over the LP: 28.21 ± 1.83; over the HH: 33.42 ± 3.10; and over the CBD: 41.66 ± 6.33), suggesting an effective sphincter-relaxing effect of glyceryl trinitrate. Conclusion: These results provide the first evidence of the effectiveness of glyceryl trinitrate on the morphine-induced sphincter of Oddi spasm in humans. Since glyceryl trinitrate is able to overcome even the drastic effect of morphine, it might be of relevance in the treatment of sphincter of Oddi dyskinesia.

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