Muscarinic Receptors and Exocrine Pancreatic Secretion

Abstract

The theoretical advantages of anticholinergic drugs for the therapy of acute pancreatitis are based on their properties, for example, relaxation of Oddi’s sphincter with possible subsequent decrease in intraductal pressure, inhibition of acid output which in turn decreases secretin-pancreozymin release, and an additional direct effect which also results in a suppression of pancreatic secretion. During the past 30 years the administration of atropine has been part of the standard therapy for acute pancreatitis (Cameron et al. 1979). Unfortunately other anticholinergic effects such as tachycardia were not tolerated by some patients (Cameron et al. 1979). Thus it was of interest to investigate the effect of pirenzepine — a more selective antimus-carinic compound (Hammer and Koss 1980) — on the exocrine pancreas as measured by the secretin-pancreozymin test and the nitro blue tetrazolium-para-ami-nobenzoic acid (NBT-PABA) test. The administration of H₂ receptor antagonists has been also recommended for the therapy of acute pancreatitis as well as during an enzyme substitution therapy in patients with impaired exocrine pancreatic function (Lankisch and Koop 1980; Meshkinpour et al. 1979). In this context the effect of ranitidine was also evaluated by the secretin-pancreozymin test and the NBT-PABA test.