Pamine bromide: gastric antisecretory effects and therapeutic usefulness in peptic ulcer and other gastrointestinal disorders.

Summary Pamine bromide, in single doses of 0.014 to 1.40 mg. intramuscularly, produced anacidity in 25 of 47 patients. Side effects developed with quantities of 0.039 mg. and increased in proportion to the dosage. Pamine produced anacidity in 22 of 57 patients given single doses of 2.5 to 25 mg. intragastrically and in two of six patients receiving 10 to 20 mg. intraduodenally. Side effects were pronounced with doses of 15 mg. or more. Pamine bromide in laminated tablets containing 5 or 10 mg. suppressed gastric secretion temporarily in three of 10 patients. Scopolamine hydrobromide orally in single doses of 0.16 to 2.24 mg. produced anacidity of brief duration in five of 15 patients. Side effects, chiefly drowsiness, developed in 11 of the 15 cases, increasing in proportion to the quantity of scopolamine. Single intramuscular injections of Pamine bromide in doses of 0.13 to 0.23 mg. decreased briefly the continuously-stimulated gastric secretion in six of eight patients. The fasting secretion for one hour, measured at intervals during the prolonged oral intake of Pamine, decreased in 13 of 15 patients. The early clinical response was judged as good or favorable in 74 of 88 patients with peptic ulcer; in six the therapy was considered insufficient. Side effects were reported by 63 of the 88 patients and necessitated discontinuation of the drug in 17. The most frequent symptoms were dryness of the mouth, blurring of vision, and constipation. The side effects decreased or apparently subsided completely during prolonged therapy in 25 patients. Treatment was terminated in 9 additional patients because of poor clinical response, other therapy or unreliability of the patient. Pamine bromide was administered orally to 37 patients with gastrointestinal disease other than peptic ulcer. Decrease in diarrhea and relief of cramping abdominal pain were noted in 11 of 16 patients with functional gastrointestinal disorders, in 7 of 10 patients with regional enteritis and in four of seven patients with severe ulcerative colitis. Symptomatic improvement was noted also in two patients with hiatus hernia and heartburn and in one individual with the post-gastrectomy syndrome. Pamine was ineffective in the one patient with chronic recurrent pancreatitis. Side effects were reported by 25 of the 37 patients in this category; in 11 cases their severity necessitated discontinuation of the drug. Treatment was terminated in eight additional patients because of inadequate clinical response. The occurrence and severity of the side effects varied greatly among individual cases. Pamine has been continued in 80 of the 125 patients. Side effects apparently were absent in 27, and were interpreted as mild in 26, moderate in 20 and severe in 7 patients. Among the 45 patients in whom Pamine was discontinued, therapy was terminated in 28 because of side effects; no attempt was made to reduce the initial dose in these patients. In 17 cases Pamine was discontinued for other reasons, principally inadequate clinical response. The prolonged oral intake of Pamine did not produce demonstrable toxic effects upon the blood, urine, hepatic function or the electrocardiogram.