title: Prolonged gastric emptying half-time and gastric hypomotility after drug overdose.
abstract: A prospective study was undertaken to determine if gastric motility and emptying are altered by the ingestion of overdoses of tricyclic antidepressants, acetaminophen, opioid-acetaminophen mixtures, carbamazepine or phenytoin. Gastric scintigraphy was used to measure gastric emptying half-time and assess gastric motility in 104 patients at initial presentation and again at follow-up (n = 85). Patients were imaged for 5 hours after being given 20 MBq of 99mTc tin colloid to drink. Drug serum levels were measured on all patients at initial presentation and at follow-up. We observed markedly prolonged gastric emptying half-times and severe hypomotility at initial presentation compared with follow-up in the vast majority of patients, except for a small group of patients with phenytoin poisoning. Twelve patients had gastric emptying half-times of over 300 minutes, a further 14 had half-times of over 200 minutes and 21 others had half-times of over 120 minutes. Poisoning is associated with hypomotility and a marked delay in gastric emptying that could influence the clinical course and patient management. These abnormalities may not be due to a direct effect of the ingested drug and factors such as stress may play a role.
authors.affiliation: Department of Nuclear Medicine, Groote Schuur Hospital, Cape Town, South Africa. bruceka@emirates.net.ae
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Adams
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mann
authors.forename: Aziz
authors.initials: A
authors.lastname: Aboo
authors.forename: Sedick
authors.initials: S
authors.lastname: Isaacs
authors.forename: Alicia
authors.initials: A
authors.lastname: Evans
mesh_terms: D000082:Acetaminophen / Q000506:poisoning; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000506:poisoning; D000701:Analgesics, Opioid / Q000506:poisoning; D000927:Anticonvulsants / Q000506:poisoning; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning; D002220:Carbamazepine / Q000506:poisoning; D002491:Central Nervous System Agents / Q000506:poisoning*; D003102:Colloids; D062787:Drug Overdose; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000187:drug effects*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000506:poisoning; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013270:Stomach / Q000000981:diagnostic imaging / Q000187:drug effects; D017556:Technetium Compounds; D017971:Tin Compounds
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D002491:Central Nervous System Agents; D003102:Colloids; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid; D002220:Carbamazepine; D000082:Acetaminophen; D010672:Phenytoin