Wienbeck M, Bohn M
Z Gastroenterol. 1985 Apr;23(4):175-82.
Besides their action on intestinal absorption and secretion antidiarrheal agents may affect gastrointestinal motility. Little is known about motor actions in the large intestine. Therefore, the effects of loperamide and lidamidine on contractile and myoelectrical activity were studied in strips of the circular muscle of the cat colon in vitro. Both drugs caused a concentration dependent increase in spontaneous contractions, but the potency of loperamide was greater than that of lidamidine and the efficacy of lidamidine greater than that of loperamide. The corresponding EC50 were 2.9 X 10(-9) M and 1.4 X 10(-5) M, respectively, and the EC100 2.7 X 10(-7) M and 10(-4) M, respectively. In the myoelectrical tracings loperamide stimulated predominantly spike activity, lidamidine oscillatory potentials. The effect of loperamide was antagonized by naloxone, thus indicating an action on opiate receptors. The effect of lidamidine was not inhibited by a variety of drugs. Tetrodotoxin and alpha-adrenergic inhibitors even exaggerated the lidamidine effect, probably by a suppression of tonic nervous inhibition. The receptor for the lidamidine action has yet to be determined. In conclusion, the motor effects may play an important role in the antidiarrheal action of loperamide, but probably not in that of lidamidine, at least not within the range of clinically used doses.
除了对肠道吸收和分泌的作用外,止泻药还可能影响胃肠动力。关于大肠的动力作用了解甚少。因此,在体外对猫结肠环行肌条进行了洛哌丁胺和利达脒对收缩和肌电活动影响的研究。两种药物均引起自发性收缩浓度依赖性增加,但洛哌丁胺的效力大于利达脒,而利达脒的效能大于洛哌丁胺。相应的半数有效浓度(EC50)分别为2.9×10⁻⁹M和1.4×10⁻⁵M,100%有效浓度(EC100)分别为2.7×10⁻⁷M和10⁻⁴M。在肌电描记图中,洛哌丁胺主要刺激锋电位活动,利达脒刺激振荡电位。洛哌丁胺的作用被纳洛酮拮抗,因此表明其作用于阿片受体。利达脒的作用未被多种药物抑制。河豚毒素和α-肾上腺素能抑制剂甚至增强了利达脒的作用,可能是通过抑制紧张性神经抑制。利达脒作用的受体尚未确定。总之,动力作用可能在洛哌丁胺的止泻作用中起重要作用,但在利达脒的止泻作用中可能不起作用,至少在临床使用剂量范围内不起作用。