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Article
Effect of the somatostatin analogue SMS-201-995 on the adrenergic response to glucose ingestion in patients with postprandial hypotension
The American Journal of Medicine
  • R. D. Hoeldtke
  • Gerald E. Dworkin, Philadelphia College of Osteopathic Medicine
  • S. Gaspar
  • B. C. Israel
Document Type
Article
Publication Date
1-1-1989
Abstract

purpose: The somatostatin analogue SMS-201-995 has recently been introduced as a new therapy for postprandial hypotension in patients with autonomic neuropathy. The present study was performed to determine the effect of SMS-201-995 on the adrenergic response to glucose ingestion in patients with this disorder. patients and methods: Eleven patients with postprandial hypotension were studied: six with central autonomic dysfunction (multiple system atrophy) and five with peripheral sympathetic dysfunction (progressive autonomic failure). Patients received either a subcutaneous injection of SMS-201-995 or a placebo injection, immediately before administration of a 50-g glucose drink. Each treatment was given on separate, consecutive days in a randomized fashion. results: Glucose ingestion caused a decrease in blood pressure (from 82 ± 6 mm Hg to 66 ± 7 mm Hg, p <0.01) and an increase in plasma norepinephrine level (165 ± 20 pg/mL to 305 ± 85 pG/m, p <0.01) in five patients with progressive autonomic failure. Administration of SMS-201-995 prevented both the decline in blood pressure and the increase in norepinephrine. By contrast, glucose ingestion elicited no increase in plasma norepinephrine levels despite profound hypotension (average post-prandial mean blood pressure, 55 ± 3 mm Hg) in six patients with multiple system atrophy. Administration of SMS-201-995 prevented postprandial hypotension in these patients, but had no effect on plasma norepinephrine. conclusion: Our data indicate that the pressor effect of SMS-201-995 is independent of the sympathetic nervous system in patients with multiple system atrophy, but may suppress the adrenergic response to glucose ingestionin patients with progressive autonomic failure. © 1989.

Comments

This article was published in The American Journal of Medicine, Volume 86, Issue C, Pages 673-677.

The published version is available at http://dx.doi.org/10.1016/0002-9343(89)90442-7.

Copyright © 1989.

Citation Information
R. D. Hoeldtke, Gerald E. Dworkin, S. Gaspar and B. C. Israel. "Effect of the somatostatin analogue SMS-201-995 on the adrenergic response to glucose ingestion in patients with postprandial hypotension" The American Journal of Medicine Vol. 86 Iss. C (1989) p. 673 - 677
Available at: http://works.bepress.com/gerald_dworkin/7/