title: Ranitidine compared to cimetidine in multiagent pharmacological treatment of porcine Pseudomonas ARDS.
abstract: The effects of two pharmacologically distinct histamine H2 receptor antagonists were studied in combination with ibuprofen (I) and diphenhydramine (D) in a porcine model of septic ARDS. Cimetidine (C) is reported as having direct oxygen radical scavenging abilities and is an inhibitor of cytochrome P-450, whereas ranitidine (R) acts solely by H2 receptor blockade. Four groups were studied: Group Ps (n = 8) received a continuous infusion of live Pseudomonas aeruginosa 5 x 10(8) CFU/ml at 0.3 ml/20kg/min, Group C (n = 6) received a control saline infusion, and the treatment groups received I (12.5 mg/kg) and D (10 mg/kg) in combination with either C (150 mg, CID, n = 6) or R (25 mg, RID, n = 5) given at 20 and 120 minutes after the onset of Ps. Pulmonary (PAP) and systemic (SAP) arterial pressures, cardiac index (CI), PaO2, thermal cardiogreen extravascular lung water (EVLW) and scintigraphically determined pulmonary albumin flux (slope index, SI) were measured. Ps infusion produced significant (p less than 0.05) cardiovascular collapse, hypoxemia and increased EVLW and SI. Both CID and RID temporarily reversed pulmonary arterial hypertension and maintained PaO2, EVLW, SAP and CI at control levels throughout the study, and significantly improved SI at 180 min. These results suggest that cimetidine and ranitidine act in this combination therapy primarily as H2 receptor antagonists.
authors.affiliation: Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23229.
authors.forename: K
authors.initials: K
authors.lastname: Byrne
authors.forename: T D
authors.initials: TD
authors.lastname: Sielaff
authors.forename: P D
authors.initials: PD
authors.lastname: Carey
authors.forename: J L
authors.initials: JL
authors.lastname: Tatum
authors.forename: C R
authors.initials: CR
authors.lastname: Blocher
authors.forename: A
authors.initials: A
authors.lastname: Vasquez
authors.forename: J I
authors.initials: JI
authors.lastname: Hirsh
authors.forename: H J
authors.initials: HJ
authors.lastname: Sugerman
mesh_terms: D000818:Animals; D002927:Cimetidine / Q000008:administration & dosage / Q000627:therapeutic use*; D004155:Diphenhydramine / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006439:Hemodynamics / Q000187:drug effects*; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000503:physiopathology; D011899:Ranitidine / Q000008:administration & dosage / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012129:Respiratory Function Tests; D012772:Shock, Septic / Q000188:drug therapy* / Q000382:microbiology; D013552:Swine
chemical_list: D002927:Cimetidine; D011899:Ranitidine; D004155:Diphenhydramine; D007052:Ibuprofen