Inhibition of basal and stimulated gastric H+ and pepsin secretion in duodenal ulcer patients by metiamide, an H-2 histamine antagonist.
Metiamide was given orally in one dose of 200 mg in 23 sutdies in patients with duodenal ulcer, 4 in the basal state, 11 during histamine infusion, and 8 before insulin hypoglycemia stimulation. In the latter 8 patients insulin was given at another time without metiamide. In 17 studies acid secretion was suppressed by metiamide--up to 75% in the basal state, 53% after histamine, and 80% after insulin. Pepsin secretion was reduced to the same extent as H+ in the histamine studies but not in the basal (57%) or insulin (44%) studies, so that in the latter pepsin/acid ratios were 3-fold greater than in controls. Blood levels of metiamide were measured in 17 studies. In 10 out of 11 who showed inhibition of 40% or more, peak blood levels of metiamide were 0.45 mug/ml to 1.25 mug/ml. In 5 of 6 who did not show inhibition, blood levels were 0.05-0.4 mug/ml; in the sixth it was 0.8 mug/ml. Therefore a critical blood level for suppression of basal or stimulated secretion appears to be approximately 0.45 mug/ml.
D000293:Adolescent; D000328:Adult; D004381:Duodenal Ulcer / Q000378:metabolism*; D005260:Female; D005750:Gastric Juice / Q000378:metabolism*; D006632:Histamine; D006801:Humans; D007003:Hypoglycemia / Q000503:physiopathology; D007328:Insulin; D008297:Male; D008785:Metiamide / Q000097:blood / Q000494:pharmacology*; D008875:Middle Aged; D010434:Pepsin A / Q000378:metabolism*; D013890:Thiourea / Q000031:analogs & derivatives*
D007328:Insulin; D008785:Metiamide; D006632:Histamine; D010434:Pepsin A; D013890:Thiourea