Zusammenfassung
Fragestellung Metoclopramid wird seit
längerem wegen seiner Wirkung auf den Magen-Darm-Trakt auch in der
Schwangerschaft verwendet. Über eine etwaige Wirkung auf den schwangeren
Uterus ist nichts bekannt. Es war daher von Interesse, Veränderungen der
uterinen Aktivität nach Applikation einer klinisch relevanten Dosis von
Metoclopramid zu untersuchen.
Material und Methode Zu diesem Zweck wurden
Streifenpräparate von insgesamt 24 schwangeren Uteri während einer
Sektio gewonnen, in eine Organkammer verbracht und die Veränderung der
Spontanaktivität nach Zugabe von Metoclopramid gemessen.
Ergebnisse Es zeigte sich ein
hochsignifikanter Abfall der uterinen Aktivität.
Schlussfolgerung Daraus ergibt sich, dass
Metoclopramid am Uterus, im Gegensatz etwa zum Magen und zum Ureter, nicht eine
tonisierende, sondern eine relaxierende Wirkung entfaltet.
Background Because of its activity on the
gastro-intestinal tract metoclopramide is used also in pregnancy, though
nothing is known about its effect on the pregnant uterus. Therefore it was of
interest to look after a change in uterine activity after the application of
metoclopramide in a clinical relevant dose.
Materials and Methods 24 strips from pregnant
uteri were removed during a cesarean section, brought into an organ chamber and
changes of spontaneous activity after the application of metoclopramide were
measured.
Results A highly significant decrease of
uterine activity was observed.
Conclusions It was demonstrated that
metoclopramide, in contrast to stomach and ureter, exerts not a tonifying but
a
relaxant effect on the uterus.
Schlüsselwörter
Uterine Kontraktilität - Dopaminantagonismus
Key words
Uterine contractility - dopamine antagonism
Literatur
1 Eingang: 27. 7. 1999Angenommen:
27. 10. 1999
- 01
Aono T, Shioji
T, Kinugasa T, Onishi
T, Kurachi K.
Clinical and endrocrinological analyses of patients with
galactorrhea and menstrual disorders due to sulpiride or metoclopramide.
J of Clin Endocrinol and Metabolism.
1978;;
47/3:
675-680
- 02 Bohnet H G. Prolaktin und seine Bedeutung für die Frau.
Fortschritte der Fertilitätsforschung FDF 9,. Grosse Verlag Berlin,; 1981:
- 03
Broc-Utne
J G, Dow
T GB, Welman
S, Dimopoulos
G E, Moshal M.
The effect of metoclopramide on the lower oesophageal
sphincter in late pregnancy.
Anaesthesia.
1978;;
6/1:
26-29
- 04
Cooke
R D, Comyn
D J, Ball R W.
Prevention of postoperative nausea and vomiting by
domperidone. A doubleblind randomized study using domperidone, metoclopramide
and a placebo.
South Afr Med J.
1979;;
56/21:
827-829
- 05
Desmond
P V, Watson
K JR.
Metoclopramide - a review.
Med J Aust.
1986;;
144:
366-369
- 06
Dodds L J.
The control of cancer chemotherapy-induced nausea and
vomitting.
J Clin Hosp Pharm.
1985;;
10:
143-166
- 07 Gralla
R J, Kris
M G, Tyson
L B, Clark R A. Controlling emesis in patients receiving cancer
chemotherapy. In: Senn HJ, Glaus A, Schmid L (eds):
Supportive care in cancer patients. Springer Verlag Berlin, Heidelberg, New York, London, Paris Tokyo; 1988;: 89-101
- 08
Gralla
R J, Tyson
L B, Kris M G, Clark
R A.
The management of chemotherapy-induced nausea and
vomiting.
Med Clin North Am.
1987;;
71:
289-301
- 09
Grimes
J D, Hassan
M N, Krelina M.
Long term follow up of tardive dyskinesia due to
metoclopramide.
Lancet.
1982b;;
2:
563
- 10
Grimes
J D, Hassan
M N, Preston
D N.
Adverse neurologic effects of metoclopramide.
Can Med Assoc J.
1982a;;
126
- 11
Grimes J D.
Parkinsonism and tardive dyskinesia associated with long-term
metoclopramide therapy.
New Engl J of Med.
1981;;
305:
1417
- 12
Guzman V, Toscano
G, Canales
E S, Zarate A.
Improvement of defective lactation by using oral
metoclopramide.
Acta Obstet Gynaec Scand.
1979;;
58/1:
53-55
- 13
Harrington
R A, Hamilton
C W, Brogden
R N, Linkewich
J A, Romankiewicz
J A, Heel R C.
Metoclopramide. An updated review of its pharmacological
properties and clinical use.
Drugs.
1983;;
25:
451-494
- 14
Jungmann
E, Schöffling K.
Die Wirkung von Metoclopramid auf Endokrinium und
Stoffwechsel.
Kali-Pharma.
1980;
- 15
Hey
V MF, Ostick
D G.
Metoclopramide and the gastrooesophageal sphincter. A study
in pregnant women with heartburn.
Anaestesia.
1978;;
33:
462-465
- 16
Kebabian
J W, Calne D B.
Multiple receptors for dopamine.
Nature.
1979;;
277:
93-96
- 17 Kebabian
J W, Tsuruta K, Cote
T E, Crewe C W. The activity of substituted benzamides in biochemical models
of dopamine receptors. In: Rotrosen and Stanley (Eds):
The Benzamides: Pharmacology, Neurobiology and Clinical
Aspects. Raven Press, New York; 1982;: 17-49
- 18
Koelz H R.
Treatment of reflux oesophagitis with H2-blockers,
antacids and prokinetic drugs.
Scand J Gastroenterol.
1989;;
24 suppl 156:
25-36
- 19
Larsen J V.
Obstetric analgesia and anaethesia.
Clin in Obstet Gyn.
1982;;
9/3:
685-710
- 20
Leatham A M.
Safety and efficacy of antiemetics used to treat nausea and
vomiting in pregnancy.
Clin Pharm.
1986;;
5:
660-668
- 21
Lechner W, Sölder
E, Bergant A.
Wirkung von Dopamin auf die uterine Kontraktilität.
Zentralbl Gynäkol.
1996;;
118:
406-408
- 22
Lewis
P J, Devenish C, Kahn
C.
Controlled trial for metoclopramine in the initiation of
breast feeding.
Br J Clin Pharmac.
1989;;
9/2:
217-219
- 23
McCallum
R W, Sowers
R W, Hershman
J M, Sturdevant
R AL.
Metoclopramide stimulates prolactin sectretion in man.
Clinical Research.
1975a;;
23:
479A
- 24
Mitterschiffthaler G.
Klinische Aspekte zur Pramedikation in der Geburtshilfe.
Anaestesiology & Reanimation.
1989;;
14/5:
275-283
- 25
Pinder
R M, Brogden
R N, Sawyer
P R, Speight
T M, Avery G S.
Metoclopramide: A review of its pharmacological properties
and clinical use.
Drugs.
1976;;
12:
81-131
- 26
Rosenblatt
W H, Cioffi
A M, Sinatra
R, Silverman D G.
Metraclopramide-enhanced analgesia for prostaglandin-induced
termination of pregnany.
Anest Analges.
1992;;
75:
760-763
- 27
Sanger
G J, King F D.
From metoclopramide to selective gut motility stimulants and
5 HT3 receptor antagonists.
Drugs Des Del.
1988;;
3:
243-295
- 28
Schelin S.
Observations on the effect of metoclopramide (Primperan) on
the human ureter.
Scand J of Urol and Nephrol.
1979;;
13:
79-82
- 29 Singh
M S, Lean T H. The use of metoclopramide (Maxlon) in hyperemesis
gravidarum.
Proceedings of the Obstetrical and Gynaecological
Society,. Singapore; 1970;: 1/43
- 30
Spiess W.
Motilium vor Anaesthesien zum Kaiserschnitt. Ein Vorschlag
zur Verminderung des Aspirationsrisikos.
Anaesthesist.
1980;;
29/8:
442-443
- 31
Vella L, Francis
D, Houlton P, Reynolds
F.
Comparison of the antiemetics metoclopramid and promethazine
in labour.
Br Med J.
1985;;
290:
1173-1175
Univ.-Prof. Dr. Wolfgang Lechner
Univ.-Klinik für Frauenheilkunde
Anichstraße 35
6020 Innsbruck
Österreich
Phone: Tel. (05 12) 5 04-31 14
Fax: Fax (05 12) 5 04-30 55