title: Effect of doses of glucagon used to treat food impaction on esophageal motor function of normal subjects.
abstract: We studied 10 normal subjects to determine the effect of doses of intravenous glucagon used to treat food impaction on esophageal motor function. With a multilumen assembly perfused by a low compliance pneumohydraulic infusion pump, esophageal manometry was performed during baseline and after randomized administration of 0. 25, 0.5, and 1 mg intravenous glucagon. Mean proximal and distal amplitudes of contraction, proximal and distal amplitude of contraction duration, lower esophageal sphincter (LES) resting pressure, percentage of LES relaxation, and glucagon-related side effects were evaluated. No effect on proximal amplitude of contraction and proximal or distal esophageal contraction duration was noted. Mean amplitude of contraction in the distal esophagus was further reduced with increased dosage of glucagon but did not achieve statistical significance. Mean LES resting pressure was significantly reduced after 0.25 mg (18.7 +/- 1.8 vs. 10.2 +/- 1.5 mmHg, p = 0.0001) and further reduced after 0.5 mg (5.9 +/- 1.2 mmHg, p = 0.0009). Mean LES relaxation was significantly reduced after 0. 25 mg (93.1 +/- 2.4% vs. 63.6 +/- 8.8%, p = 0.0031). The 1-mg dose versus the 0.5-mg did not provide further reduction in any LES function parameters. One subject experienced transient nausea after 0.5 mg, and 4 subjects experienced nausea after 1 mg glucagon. In conclusion, increased doses of glucagon further reduce mean distal esophageal amplitude of contraction. Although maximum reduction in mean LES resting pressure was achieved with 0.5 mg, it did not provide any potential therapeutic advantage over 0.25 mg glucagon. Nausea is a common, transient side effect predominantly affecting subjects treated with the 1-mg dose.
authors.affiliation: Department of Medicine, Section of Gastroenterology, Tucson VA Medical Center, Tuscon, Arizona 85723, USA.
authors.forename: V
authors.initials: V
authors.lastname: Colon
authors.forename: A
authors.initials: A
authors.lastname: Grade
authors.forename: G
authors.initials: G
authors.lastname: Pulliam
authors.forename: C
authors.initials: C
authors.lastname: Johnson
authors.forename: R
authors.initials: R
authors.lastname: Fass
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000188:drug therapy; D004943:Esophagogastric Junction / Q000187:drug effects; D004947:Esophagus / Q000187:drug effects*; D005260:Female; D005502:Food; D005547:Foreign Bodies / Q000188:drug therapy; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005934:Glucagon / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects; D009325:Nausea / Q000139:chemically induced; D010528:Peristalsis / Q000187:drug effects; D011312:Pressure
chemical_list: D005765:Gastrointestinal Agents; D005934:Glucagon