Octreotide enhances the accelerating effect of erythromycin on gastric emptying in healthy subjects.
BACKGROUND
Erythromycin exhibits gastrokinetic properties through cholinergic pathways. Reports regarding the action of octreotide on gastric emptying are conflicting.


OBJECTIVE
: To assess: (i) the hypothesis that serotonin receptors are involved in the accelerating effect of erythromycin on gastric emptying; and (ii) any modification of the gastrokinetic action of erythromycin induced by octreotide.


METHODS
Gastric emptying of a standard meal was estimated in 20 healthy subjects by scintigraphy on three different occasions in a double-blind, placebo-controlled manner and in random order: (i) after placebo; (ii) after 200 mg of intravenous erythromycin; and (iii) after 200 mg of intravenous erythromycin following pre-treatment with either 4 mg of intravenous ondansetron (10 subjects) or 50 micro g octreotide.


RESULTS
Erythromycin significantly accelerated gastric emptying in all subjects by abolishing the lag phase. Pre-treatment with ondansetron abolished the accelerating effect of erythromycin by restoring the emptying times to placebo levels. Octreotide significantly enhanced the accelerating effect of erythromycin by reducing both the lag and post-lag phases of gastric emptying.


CONCLUSIONS
Serotonin receptors are involved in the accelerating effect of erythromycin on gastric emptying. This effect seems to be enhanced by pre-treatment with octreotide, possibly as a result of the modification of the gastrointestinal hormonal environment.
Laboratory of Gastrointestinal Motility, University Hospital of Heraklion, Medial School, University of Crete, Grece.
E
E
Athanasakis
E
E
Chrysos
O J
OJ
Zoras
J
J
Tsiaoussis
N
N
Karkavitsas
E
E
Xynos
D000328:Adult; D004311:Double-Blind Method; D004357:Drug Synergism; D004917:Erythromycin / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D008297:Male; D015282:Octreotide / Q000494:pharmacology*; D017294:Ondansetron / Q000494:pharmacology; D019275:Radiopharmaceuticals; D012702:Serotonin Antagonists / Q000494:pharmacology; D013671:Technetium Tc 99m Sulfur Colloid
D005765:Gastrointestinal Agents; D019275:Radiopharmaceuticals; D012702:Serotonin Antagonists; D017294:Ondansetron; D013671:Technetium Tc 99m Sulfur Colloid; D004917:Erythromycin; D015282:Octreotide