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. 1984 Nov;25(11):1211–1216. doi: 10.1136/gut.25.11.1211

Effect of no treatment, cimetidine 1 g/day, cimetidine 2 g/day and cimetidine combined with atropine on nocturnal gastric secretion in cimetidine non-responders.

T Gledhill, M Buck, R H Hunt
PMCID: PMC1432313  PMID: 6542048

Abstract

We have studied nocturnal acid secretion in patients with duodenal ulcer who met predetermined criteria of poor clinical response to cimetidine. Different groups of patients were investigated receiving either no treatment, cimetidine 1 g/day, cimetidine 2 g/day or cimetidine 1 g/day combined with atropine 4.8 mg/day. The results were compared with those obtained from other patients with duodenal ulcer who were studied in our department but who were not classified as according to their clinical response to cimetidine. The results show that despite adequate absorption, cimetidine has a decreased effect at controlling acid secretion in the poor responders and that increasing the dose of drug does not improve response. Control of acid output was, however, dramatically improved when cimetidine was combined with atropine which suggests that patients who do not respond to H2-receptor blockade should be treated by a combination of cimetidine with an anticholinergic agent.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bardhan K. D. Intermittent treatment of duodenal ulcer with cimetidine. Br Med J. 1980 Jul 5;281(6232):20–22. doi: 10.1136/bmj.281.6232.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Blackwood W. S., Maudgal D. P., Pickard R. G., Lawrence D., Northfield T. C. Cimetidine in duodenal ulcer. Controlled trial. Lancet. 1976 Jul 24;2(7978):174–176. doi: 10.1016/s0140-6736(76)92347-3. [DOI] [PubMed] [Google Scholar]
  3. Cargill J. M., Saunders J. H., Peden N., Wormsley K. G. Very long-term treatment of peptic ulcer with cimetidine. Lancet. 1978 Nov 25;2(8100):1113–1115. doi: 10.1016/s0140-6736(78)92273-0. [DOI] [PubMed] [Google Scholar]
  4. Feldman M., Richardson C. T., Peterson W. L., Walsh J. H., Fordtran J. S. Effect of low-dose propantheline on food-stimulated gastric acid secretion: comparison with an "optimal effective dose" and interaction with cimetidine. N Engl J Med. 1977 Dec 29;297(26):1427–1430. doi: 10.1056/NEJM197712292972603. [DOI] [PubMed] [Google Scholar]
  5. Hetzel D. J., Hansky P. J., Shearman D. J., Korman M. G., Hecker R., Taggart G. J., Jackson R., Gabb B. W. Cimetidine treatment of duodenal ulceration: short term clinical trial and maintenance study. Gastroenterology. 1978 Feb;74(2 Pt 2):389–392. [PubMed] [Google Scholar]
  6. Hunt R. H. Use and abuse of H2 receptor antagonists. J R Coll Physicians Lond. 1982 Jan;16(1):33–39. [PMC free article] [PubMed] [Google Scholar]
  7. Kirkpatrick P. M., Jr, Hirschowitz B. I. Duodenal ulcer with unexplained marked basal gastric acid hypersecretion. Gastroenterology. 1980 Jul;79(1):4–10. [PubMed] [Google Scholar]
  8. Mohammed R., Mitchell K. G., Mackay C. The treatment of "cimetidine resistant" peptic ulcers by ranitidine hydrochloride: a new histamine H2-receptor antagonist. Curr Med Res Opin. 1981;7(8):523–525. doi: 10.1185/03007998109112368. [DOI] [PubMed] [Google Scholar]
  9. Peterson W. L., Barnett C., Feldman M., Richardson C. T. Reduction of twenty-four-hour gastric acidity with combination drug therapy in patients with duodenal ulcer. Gastroenterology. 1979 Nov;77(5):1015–1020. [PubMed] [Google Scholar]
  10. Pounder R. E., Hunt R. H., Vincent S. H., Milton-Thompson G. J., Misiewicz J. J. 24-hour intragastric acidity and nocturnal acid secretion in patients with duodenal ulcer during oral administration of cimetidine and atropine. Gut. 1977 Feb;18(2):85–90. doi: 10.1136/gut.18.2.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pounder R. E., Williams J. G., Milton-Thompson G. J., Misiewicz J. J. Effect of cimetidine on 24-hour intragastric acidity in normal subjects. Gut. 1976 Feb;17(2):133–138. doi: 10.1136/gut.17.2.133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Randolph W. C., Osborne V. L., Walkenstein S. S., Intoccia A. P. High-pressure liquid chromatographic analysis of cimetidine, a histamine H2-receptor antagonist, in blood and urine. J Pharm Sci. 1977 Aug;66(8):1148–1150. doi: 10.1002/jps.2600660825. [DOI] [PubMed] [Google Scholar]
  13. SUN D. C. LONG-TERM ANTICHOLINERGIC THERAPY FOR PREVENTION OF RECURRENCES IN DUODENAL ULCER. Am J Dig Dis. 1964 Oct;9:706–716. doi: 10.1007/BF02237730. [DOI] [PubMed] [Google Scholar]
  14. Walt R. P., Male P. J., Rawlings J., Hunt R. H., Milton-Thompson G. J., Misiewicz J. J. Comparison of the effects of ranitidine, cimetidine and placebo on the 24 hour intragastric acidity and nocturnal acid secretion in patients with duodenal ulcer. Gut. 1981 Jan;22(1):49–54. doi: 10.1136/gut.22.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Walt R. P., Trotman I. F., Frost R., Golding P. L., Shepherd T. H., Rawlings J., Hunt R. H., Colin-Jones D., Milton-Thompson G. J., Misiewicz J. J. Comparison of twice-daily ranitidine with standard cimetidine treatment of duodenal ulcer. Gut. 1981 Apr;22(4):319–322. doi: 10.1136/gut.22.4.319. [DOI] [PMC free article] [PubMed] [Google Scholar]

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