Abstract from American College of Clinical Pharmacy 1997 Annual Meeting, Phoenix, AZ, November 9-12, 1997

Brown, Rex O.

Dickerson, Roland N.

Gervasio, Jane M.

Headley, Stacey

Kudsk, Kenneth A.

Kuhl, David A.

Lima, John J.

Livingston, Teresa N.

MacLaren, Robert

Swift, Kyle

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Butler UniversityDigital Commons @ Butler UniversityScholarship and Professional Work – COPHS College of Pharmacy & Health Sciences9-1997Enteral cisapride, erythromycin, andmetoclopramide in critically ill patients intolerantto enteral nutrition: a randomized,placebocontrolled, cross-over studyRobert MacLarenJane M. GervasioButler University, jgervasi@butler.eduDavid A. KuhlTeresa N. LivingstonKyle SwiftSee next page for additional authorsFollow this and additional works at: http://digitalcommons.butler.edu/cophs_papersPart of the Pharmacy and Pharmaceutical Sciences CommonsThis Article is brought to you for free and open access by the College of Pharmacy & Health Sciences at Digital Commons @ Butler University. It hasbeen accepted for inclusion in Scholarship and Professional Work – COPHS by an authorized administrator of Digital Commons @ Butler University.For more information, please contact fgaede@butler.edu.Recommended CitationMacLaren, Robert; Gervasio, Jane M.; Kuhl, David A.; Livingston, Teresa N.; Swift, Kyle; Dickerson, Roland N.; Brown, Rex O.;Headley, Stacey; Kudsk, Kenneth A.; and Lima, John J., "Enteral cisapride, erythromycin, and metoclopramide in critically ill patientsintolerant to enteral nutrition: a randomized, placebocontrolled, cross-over study" (1997). Scholarship and Professional Work –COPHS. Paper 27.http://digitalcommons.butler.edu/cophs_papers/27AuthorsRobert MacLaren, Jane M. Gervasio, David A. Kuhl, Teresa N. Livingston, Kyle Swift, Roland N. Dickerson,Rex O. Brown, Stacey Headley, Kenneth A. Kudsk, and John J. LimaThis article is available at Digital Commons @ Butler University: http://digitalcommons.butler.edu/cophs_papers/27Enteral cisapride, erythromycin, and metoclopramide in critically ill patients intolerant to enteral nutrition: a randomized, placebocontrolled, cross-over study !Rob MacLaren, Jane M. Gervasio, David A. Kuhl, Teresa N. Livingston, D. Kyle Swift, Roland N. Dickerson, Rex O. Brown, A. Stacey Headley, Kenneth A. Kudsk, John J. Lima !!Purpose: To evaluate the comparative efficacies of enteral cisapride (CIS), erythromycin (ERY), metoclopramide (MET), and placebo (PLA) for promotion of gastric emptying in critically ill patients intolerant to gastric enteral nutrition (EN). !Methods: Ten critically ill patients with an aspirated gastric residual volume (GRV) greater than 150 ml receiving EN were administered a single enteral dose of CIS 10 mg, ERY 200 mg, MET 10 mg, and PLA (water) every 12 hours in a randomized, cross-over manner. Acetaminophen solution (1 g) was administered concurrently with each dose to evaluate gastric emptying. GRVs were assessed and plasma acetaminophen concentrations were serially determined by TDx between 0 and 12 hours. Compartmental pharmacokinetic methods were used to calculate absorption lag time (thg), mean residence time of absorption (MRTabs), time to peak concentration (tP), elimination rate constant (k), and area under the plasma concentration- time curve (AUC). Statistical analysis included ANOVA and post hoc comparison using Fisher's LSD. !Results: GRVs during the study were not significantly different between agents. Pharmacokinetic parameters (mean ± SD) varied as follows: Agent (n) tLag (min) MRTabs (min) tP (min)  k (1/min × 10-2)  AUC (mg/L/min) CIS (6)  20.8 ± 16.5 4.6 ± 3.6 * 23.1 ± 0.6*+ 0.766 ± 0.493  1774 ± 1190 ERY (8)  13.1 ± 18.3 28.1 ± 26.6 65.2 ± 26.8 0.839 ± 0.539  2306 ± 1253 MET (8)  7.9 ± 14.6 8.6 ± 12.7* 39.8 ± 9.8*+ 0.847 ± .0451  2255 ± 1472 PLA (8)  12.5 ± 18.1 20.5 ± 17.8 69.2 ± 13.4 0.650 ± 0.230  2582 ± 1586 *p < 0.05 versus ERY; +p < 0.05 versus PLA !"1Conclusions: In critically ill patients intolerant to enteral nutrition, a single enteral dose of cisapride or metoclopramide significantly accelerated gastric emptying compared to erythromycin and placebo. Erythromycin provided no advantage over placebo."2

Enteral cisapride, erythromycin, and metoclopramide in critically ill patients intolerant to enteral nutrition: a randomized, placebocontrolled, cross-over study

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Enteral cisapride, erythromycin, and metoclopramide in critically ill patients intolerant to enteral nutrition: a randomized, placebocontrolled, cross-over study

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