Efficacy Of Cimetidine Research Articles

Efficacy of cimetidine in treatment of RAU

目的 观察西咪替丁治疗复发性口腔溃疡的效果.方法 将420例复发性口腔溃疡患者,随机分成对照组和治疗组,对照组(240例)应用华素片、维生素C、维生素B2及抗感染治疗;治疗组(180例)在对照组基础上加用西咪替丁0.2 g,每日3次口服,局部涂撒西咪替丁粉末,疗程7 d.结果 治疗组痊愈和显效率分别为61.1%和27.8%,对照组分别为25.0%和25.0%,两组治疗显效率差异有统计学意义(P＜0.05).结论 西咪替丁治疗复发性口腔溃疡可快速缓解疼痛症状,疗效显著。

Antiemetic efficacy of cimetidine randomized, double-blind, crossover study with dexamethasone in cancer patients receiving emetogenic chemotherapy

In a randomized, double-blind, crossover study the antiemetic effect of cimetidine was compared with that of dexamethasone in cancer patients receiving emetogenic chemotherapy. Thirty-two patients were evaluable and all were chemotherapy-naive. Eight patients (25%) received high doses of cisplatin, 17 (53%) had cyclophosphamide in combination treatment, 2 (6%) received adriamycin, and 1 another chemotherapy of less emetogenic potential. Complete protection (CR) rates of 59.4% and 62.5% were achieved with cimetidine and dexamethasone, respectively. In addition, three (9.4%) and 1 (3%) patients attained partial protection with cimetidine and dexamethasone, respectively. No significant difference was noted between the two antiemetic therapies (p = 0.07). Although CR has not been achieved in any of those patients who received cisplatin, a comparable antiemetic effect was attained. Both antiemetic regimens were well tolerated with minimal side effects. We conclude that the antiemetic potential of cimetidine and its safety deserve further investigation in a larger study, perhaps in combination with other antiemetic agents.

Cimetidine 800 mg Twice Daily for Healing Erosions and Ulcers in Gastroesophageal Reflux Disease

Although H2-receptor antagonists have been the mainstay of therapy for gastroesophageal reflux disease (GERD), none of these agents has been approved by the FDA as effective in healing lesions. Since proton pump inhibitors may be associated with long-term disadvantages, a healing regimen with cimetidine would be useful clinically. This multicenter, randomized, double-blind study was conducted to evaluate the efficacy of cimetidine 800 mg b.i.d. in healing lesions and in providing symptomatic relief in patients with ulcerative or erosive esophagitis. Patients with greater than or equal to 8 heartburn episodes during a 1-week screening period, reflux confirmed by esophageal pH monitoring, and esophageal ulcers or erosions confirmed by endoscopy were randomized to treatment with placebo or cimetidine for 12 weeks. Cimetidine provided significantly greater (p less than 0.01) improvement (74% vs. 51%) and complete healing (67% vs. 36%) of esophageal lesions than did placebo. In these patients with erosive or ulcerative esophagitis, the median time to achieve 24 h without heartburn was 13 days with cimetidine and 30 days with placebo (p = 0.01). The mean heartburn severity score in the cimetidine group decreased rapidly during the first week and was consistently lower than in the placebo group. Cimetidine, 800 mg twice daily, is effective in promoting healing of esophageal ulcers and erosions and in providing heartburn relief in patients with symptomatic erosive/ulcerative GERD.

Cimetidine in the treatment of non-ulcer dyspepsia: Results of a randomized double-blind, placebo-controlled study

A randomized double-blind, placebo-controlled study was carried out in 56 patients with essential dyspepsia to investigate the therapeutic efficacy of cimetidine in providing symptomatic relief. Patients received either 1 tablet of cimetidine (400 mg) or identical looking placebo twice daily for a period of 4 weeks. A detailed symptomatic assessment was made at weekly intervals. Abdominal pain, the primary symptom, was relieved in a higher proportion of cimetidine-treated patients compared to placebo group (67% versus 40%, p less than 0.05). Most of the secondary gastro-intestinal symptoms also improved in a higher proportion of patients in the cimetidine group although the difference was statistically not significant. The outcome of treatment was not influenced by factors such as duration of disease, initial severity of pain and smoking habits of the patient.

The Comparative Efficacy of Cimetidine and Ranitidine in Controlling Gastric pH in Critically Ill Patients

The comparative efficacy of intravenous cimetidine and ranitidine in controlling gastric pH in 100 intensive care unit patients was assessed in a double blind, prospective, randomized study. The total number of gastric pH determinations and the number of pH determinations with pH less than five were recorded. Patients received either cimetidine or ranitidine via continuous infusion, with dosage adjustments for patients with renal insufficiency. Antacids were administered each time the gastric pH was less than five. There was no difference overall in the number of patients who had at least one gastric pH determination < pH 5. There was however, a larger proportion of patients with ≥10, ≥15, ≥20 and ≥25 per cent of gastric pH determination < pH 5 in the cimetidine group than in the ranitidine group. This difference was statistically significant for ≥25 per cent. The drugs were well tolerated. Ranitidine was as effective as cimetidine and possibly more so in controlling gastric pH.

CHANGES OF INDICATIONS FOR SURGERY AFTER THE INTRODUCTION OF CIMETIDINE

A retrospective study of patients with peptic ulcer admitted to the First Department of Surgery, School of Medicine, Kobe University, was made into the actual conditions of the surgical treatment of the ulcer after the introduction of cimetidine. The patients were divided into two groups, the first belonging to the period between 1976 and 1980 and the second belonging to that between 1981 and 1985 (July). A remarkable decrease was seen in the second group in the number of cases and operations. Especially noticeable was a decline in the number and rate due to intractability among such cases. But an increase was noted in the number of operations for complications of the ulcer (hemorrhage, perforation). There was a higher rate of complications in the second group in comparison with the first. There was no difference in the rate of occurrence of ulcers or shock. In cases of serious hemorrhage with duplicated complications, a barrier was observed in the efficacy of cimetidine, and the rate of cases requiring urgent surgery was still as high as 42.1%.

Utility of BID administration of cimetidine for gastric ulcer : A comparison with QID administration in a double blind manner.

The clinical efficacy of cimetidine for gastric ulcer was compared between the standard administration methods in Japan; 200 mg four times daily and 400 mg twice daily after breakfast and at bedtime in a double blind manner. It was found that the results obtained by 200 mg twice-daily administration were almost comparable to those obtained by the four-times-daily administration without statistically significant difference for healing rate, final global improvement in subjective and objective symptoms, incidence of adverse reactions and effects on laboratory tests. These findings resulted in that the twice-daily administration of cimetidine provides convenience for patients.

Increased Cimetidine Clearance in Burn Patients

To determine the etiology of the decreased efficacy of cimetidine in burned and critically ill surgical patients, we studied the kinetics and dynamics of the drug in eight burned patients at a mean of 12 days after the burn. The kinetics were compared with those of nine healthy controls. The elimination half-life of cimetidine in burned patients was significantly reduced (2.2 v 1.5 hours), and total clearance significantly increased (8.2 v 13.3 mL/min/kg). Creatinine and total cimetidine clearance were highly correlated with size of the burn. In the patients studied, 63% of the dose was excreted in eight hours, compared with 45% after 24 hours in controls. Gastric pH was maintained at 4 or higher as long as plasma levels of cimetidine were held above 0.5 microgram/mL. Thus, the increased clearance of cimetidine might explain the decreased effectiveness of this drug in burned and possibly other surgical patients. Dose schedules may need to be altered to compensate for the enhanced clearance of this drug.

INNOVATION IN GASTROENTEROLOGICAL MANAGEMENT: THE CASE OF CIMETIDINE

Gastroenterological medicine has, in recent decades, experienced two major innovations, viz. fibre optic endoscopy (a diagnostic technology) and cimetidine, an innovation in ulcer therapy. This paper is concerned with determining the efficacy of cimetidine in reducing the number of surgical procedures for gastric and duodenal ulcer. It is found that, since the introduction of cimetidine, a statistically significant decline in gastric ulcer operations has occurred. A similar result was not obtained for persons with a diagnosis of duodenal ulcer. The picture of substitution of therapies given by this study is in sharp contrast to that depicted in clinical drug trials. This has significance for technology assessment.

Cimetidine does not correct circulating calcium and parathyroid hormone in primary hyperparathyroidism.

Thirteen patients with primary hyperparathyroidism were treated for 4-8 weeks with the H2-blocker cimetidine at a daily dose of 1 g. The drug had no effect on the serum concentrations of calcium or parathyroid hormone, nor did any of the patients improve clinically during the period of treatment. The recently reported efficacy of cimetidine in primary hyperparathyroidism is strongly questioned by the present results.

The Use of the Haemoccult Test for Detection of Blood in Gastric Aspirates

The guaiac test has recently been used as a determinant of gastric mucosal bleeding in trials comparing different therapeutic regimens for the prevention of gastric stress ulceration. A prospective study, evaluating the efficacy of cimetidine in controlling the gastric pH in 44 patients in our intensive care unit, demonstrated a significant direct correlation between the pH of the gastric aspirate and the Haemoccult test result. The percentage of positive test results decreased progressively with declining pH. Since this seemed to contradict all modern concepts of gastric mucosal damage, we investigated further the pH-dependent sensitivity in vitro. Using different test solutions (NaCl, gastric juice, duodenal juice, and bile) we demonstrated a strong pH-dependent decrease of sensitivity to detect blood below a pH of 4. These results led to the conclusion that the guaiac test is not a valid measure of gastric mucosal bleeding unless used on buffered gastric aspirates.

Dialysis Pruritus: Effect of Cimetidine

The effect of oral Cimetidine compared to a classic antihistaminic and to a placebo was evaluated, under the double hypothesis of its anti-PTH and anti-pruritus action, in a population of patients recently included in Hemodialysis that were asked about the incidence and intensity of pruritus according to a scored questionnaire made for this purpose. No different efficacy of Cimetidine versus the antihistaminic classic and the placebo was observed in our study.

Oral cimetidine in reflux esophagitis: A double blind controlled trial

The efficacy of cimetidine (1.6 g per day) was evaluated using a double blind placebo-controlled trial in 24 patients with moderate or severe peptic reflux esophagitis. The results show that cimetidine is superior to placebo when using endoscopic and histological criteria. Improved patient symptomatology and lower antacid consumption failed to reach statistical significance. No change in the abnormally low lower esophageal sphincter pressure was observed at the end of the trial. No clinical side effects or significant biochemical changes were noted during the trial.