title: Gastric emptying response to variable oral erythromycin dosing in diabetic gastroparesis.
abstract: Intravenous erythromycin has been shown to improve gastric emptying in diabetic gastroparesis. Oral erythromycin also accelerates gastric emptying, but to a lesser degree. To determine if this is a dose-dependent phenomenon, gastric emptying was measured in 10 insulin-requiring diabetic patients with gastroparesis after administration of either 250 mg or 1000 mg of erythromycin or placebo. The drugs were orally administered in a randomized, double-blind fashion 30 min prior to ingestion of a meal containing [99mTc]-sulfur colloid-labeled beef stew and [111In]DTPA-labeled orange juice. Anterior and posterior gastric images were recorded for 3 hr at 15-min intervals using an externally positioned gamma camera. The results demonstrated that both doses of oral erythromycin significantly improved solid-phase gastric emptying. The mean half-emptying time of solids was decreased from 151 +/- 40 min with placebo to 58 +/- 10 min and 40 +/- 9 min with 250 mg and 1000 mg of erythromycin, respectively. However, a dose-dependent relationship was not demonstrated with the two doses of erythromycin employed. These results suggest that for most patients with diabetic gastroparesis, a single 250-mg dose of erythromycin will significantly improve gastric emptying. It is possible that a dose-dependent relationship will be demonstrated with doses of erythromycin less than 250 mg.
authors: Department of Medicine, University of Utah School of Medicine, Salt Lake City.
authors: S G
authors: SG
authors: Desautels
authors: W R
authors: WR
authors: Hutson
authors: P E
authors: PE
authors: Christian
authors: J G
authors: JG
authors: Moore
authors: F L
authors: FL
authors: Datz
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D004311:Double-Blind Method; D004917:Erythromycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D005746:Gastric Emptying / Q000187:drug effects*; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D004917:Erythromycin