[Treatment with clonidine in a case of the short bowel syndrome with therapy-refractory diarrhea].
A patient with refractory diarrhoea (up to 10 l/d) following colectomy and ileostomy was treated with clonidine, after loperamide, tinctura opii, cholestyramine and somatostatin had failed to reduce stool volume to less than 6 l/d. Under combined treatment with clonidine (1200 micrograms/d) and somatostatin (6 mg/d), which was well tolerated, stool weights were normalised within 24 hours. This case report on the successful anti-diarrhoeic effect of clonidine is completed by experimental data from rat jejunal and duodenal segments. In the presence of the adenylate cyclase-stimulating agent forskolin, clonidine normalised both mucosal cAMP content and cAMP-induced hypersecretion in rat intestine. This suggests that the anti-diarrhoeic effect of clonidine in-vitro results from an alpha 2-receptor mediated inhibition of the stimulated adenylate cyclase. Case report and experimental data therefore support the theory that therapeutical application of clonidine in diarrhoea may be successful.
Abteilung für Anästhesiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.
J
J
Scholz
H
H
Bause
A
A
Reymann
M
M
Dürig
D000067956:Adenylyl Cyclase Inhibitors; D000818:Animals; D003000:Clonidine / Q000494:pharmacology / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D051381:Rats; D011942:Receptors, Adrenergic, alpha / Q000187:drug effects; D012778:Short Bowel Syndrome / Q000150:complications*; D013004:Somatostatin / Q000627:therapeutic use
D000067956:Adenylyl Cyclase Inhibitors; D011942:Receptors, Adrenergic, alpha; D013004:Somatostatin; D003000:Clonidine
Zur Behandlung mit Clonidin bei kurzdarmsyndrombedingter therapierefraktärer Diarrhö.