drotaverin and Biliary-Dyskinesia

The study of 67 chronic biliary patients (36 - gallbladder dysfunction, 25 acalculuous cholecystitis, 6 - cholelithiasis) was revealed their functional dysadaptation characterized by gallbladder dysmotility and autonomic dysfunction. Vegetotropic therapy (Propranolol, Metoclopramid, Atropine) according to the autonomic regulation activity has advantages in correction of the gallbladder dysmotility in comparison to the routine pharmacotherapy. Hypobaric hypoxic adaptation results in the increase of gallbladder emptying that opens perspectives for the non-pharmacological correction of the gallbladder hypokinetic dyskinesia.

Topics: Adaptation, Physiological; Adolescent; Adrenergic beta-Antagonists; Adult; Autonomic Nervous System; Biliary Dyskinesia; Cholecystography; Dopamine Antagonists; Female; Gallbladder; Gallbladder Emptying; Humans; Hypoxia; Male; Metoclopramide; Middle Aged; Papaverine; Parasympatholytics; Propranolol; Treatment Outcome; Ultrasonography

Ninety patients aged 21 to 56 years who had chronic non-calculous cholecystitis (CNCC) concurrent with hyperkinetic dyskinesia (HKD) detectable by a stepwise duodenal probing and sonography, by using a choleretic breakfast and by determining the relaxation coefficient (RC) that was equal to the ratio of the volume of the gallbladder (GB) after the use of a spasmolytic to the baseline GB volume. The patients were divided into 3 groups. The authors used as a spasmolytic agent pinaverium bromide (dicetel) in a dose of 50 mg (1 tablet) in Group 1), octylonium bromide (spasmomen) in a dose of 40 mg (1 dragee) in Group 2, and drotaverine (no-spa) in a dose of 40 mg (1 tablet). There was a more significant sonographic increase in the size of GB in Groups 1 and 2 as compared with Group 3. In the acute drug test and during long-term treatment as well, the highest spasmolytic effect was noted in patients receiving dicetel (Group 1) and spasmomen (Group 2) as compared with that in Group 3 patients taking drotaverine. With this, RC was 1.25 +/- 0.2, 1.6 +/- 0.15, and 1.08 +/- 0.1, respectively. No adverse reactions occurred in the patients having selective calcium blockers (SCBs) whereas the patients receiving no-spa were found to have the following side effects: dry mouth (n = 3), transient constipation (n = 1), and numb tongue (n = 1). Thus, the study has provided evidence for the fact that SCBs have some advantage over myotropic spasmolytic agents in the treatment of CNCC with the signs of HKD.

Topics: Acalculous Cholecystitis; Adult; Biliary Dyskinesia; Calcium Channel Blockers; Chronic Disease; Female; Humans; Male; Middle Aged; Morpholines; Papaverine; Parasympatholytics; Quaternary Ammonium Compounds; Time Factors; Treatment Outcome; Ultrasonography

Topics: Adolescent; Adult; Benzofurans; Biliary Dyskinesia; Drug Evaluation; Hepatitis A; Hepatitis B; Humans; Middle Aged; Papaverine; Parasympatholytics