LACK OF EVIDENCE OF NEUROTOXICITY FOLLOWING 8 WEEKS OF TREATMENT WITHTRIPOTASSIUM DICITRATO BISMUTHATE

Citation
Cu. Nwokolo et al., LACK OF EVIDENCE OF NEUROTOXICITY FOLLOWING 8 WEEKS OF TREATMENT WITHTRIPOTASSIUM DICITRATO BISMUTHATE, Alimentary pharmacology & therapeutics, 8(1), 1994, pp. 45-53
Citations number
29
Categorie Soggetti
Pharmacology & Pharmacy
ISSN journal
02692813
Volume
8
Issue
1
Year of publication
1994
Pages
45 - 53
Database
ISI
SICI code
0269-2813(1994)8:1<45:LOEONF>2.0.ZU;2-W
Abstract
Objective: To search for evidence of subclinical neurotoxicity in pati ents treated with tripotassium dicitrato bismuthate. Design: Prospecti ve, controlled, triplicate study using urinary bismuth concentration, magnetic resonance imaging (MRI), nerve conduction studies, visual evo ked response and a battery of 10 neuropsychological screening tests. S etting: Out-patient clinics, Walsgrave Hospital, Coventry, UK. Subject s: Fourteen dyspeptic patients; 8 (treatment group) treated with tripo tassium dicitrato bismuthate one tablet q.d.s and 6 (control group) tr eated with ranitidine 150 mg b.d. for 8 weeks. Main outcome measures: Changes in urinary bismuth, MRI, nerve conduction studies, visual evok ed response, and neuropsychological tests performed before, immediatel y after and 8 weeks after the cessation of treatment. Results: In the treatment group the median (range) urinary bismuth concentration was 1 (1-12) ng/ml before treatment, increased to 560 (140-1300) immediatel y after treatment (P < 0.01, Wilcoxon Rank Sum test) and was still sig nificantly elevated (23 (7-53) ng/ml) 8 weeks after the cessation of t reatment. In the patient who recorded the highest urinary bismuth, a h igh intensity signal appeared in the globus pallidus immediately after treatment and was still present (though diminished in intensity) 8 we eks after the cessation of treatment. This isolated MRI finding was no t associated with evidence of subclinical neurotoxicity. No changes in the MRI, nerve conduction studies, visual evoked response and neurops ychological tests were observed among the other patients studied. Conc lusions: Bismuth accumulation occurs in patients receiving a conventio nal course of treatment with tripotassium dicitrato bismuthate but thi s is not associated with significant changes in the nervous system.