Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Today it is possible, with the available treatment armamentarium, for a physician to rationally choose a strategy to be customized to patients with type II diabetes. The keystone of treatment is a good nutritional plan that provides for proper nutrition as well as appropriate weight loss. Exercise is also a useful adjunct. When diet therapy is unsuccessful, the use of oral sulfonylureas may be indicated. These agents have been shown to stimulate insulin release, to reduce hepatic glucose output, to potentiate insulin action in a postreceptor mechanism, and to have a modest effect in increasing insulin receptors. The first-generation compounds have a 70% success rate within the first 5 years after initiating therapy. However, these agents can have undesirable side effects. The second-generation agents, such as glipizide, offer the advantages of high efficacy, inactive metabolites, nonionic binding, and low reported alcohol flushing. Many patients who fail on first-generation agents may respond to second-generation drugs. Insulin therapy can be used if the patient fails on an oral agent.
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PMID:Determining the most appropriate treatment for patients with non-insulin-dependent diabetes mellitus. 354 17

The effect of pretreating a polyvinyl chloride i.v. administration system with sodium chloride or insulin solution on the delivery of insulin was studied. Insulin labeled with iodine 125 was added to human insulin, which was added to 0.9% sodium chloride injection packaged in flexible polyvinyl chloride containers and to 0.9% sodium chloride injection placed in empty ethylene vinyl acetate containers. Samples were tested for insulin content by gamma spectrometry after storage in the bags and after infusion through four different polyvinyl chloride administration sets at different flow rates. Effluent samples were collected at 10 times (6-50 minutes) after the start of the infusion. The 0.9% sodium chloride injection had a conditioning effect on the polyvinyl chloride administration sets, indicating an electrostatic sorption mechanism for insulin. Sorption to the untreated polyvinyl chloride sets and the ethylene vinyl acetate bags was substantial and followed a Langmuir adsorption isotherm. Insulin sorption to the untreated administration sets was greatest from the first 100 mL of effluent and did not differ by flow rate or type of set investigated. Storing the sodium chloride injection in the tubing for one hour or flushing the tubing with 100 mL of sodium chloride injection or 100 mL of the insulin admixture decreased sorption by half. Storing the insulin admixture in the tubing for 30 minutes caused sorption to be reduced by a factor of three. When either of the solutions was stored in the set and then the set was flushed with the solution, sorption was even further suppressed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of pretreatment with 0.9% sodium chloride or insulin solutions on the delivery of insulin from an infusion system. 376 74

A single intravenous injection of four hypothalamic releasing hormones-corticotropin-, growth hormone-, gonadotropin- and thyrotropin-releasing hormones-was administered to normal subjects. Except for the plasma adrenocorticotropic hormone (ACTH) level, a statistically significant increase in all anterior pituitary hormone levels occurred. Transient flushing was the only consistent side effect. In the same persons, results were compared with those obtained with insulin-induced hypoglycemia and a single-dose overnight metyrapone test. Growth hormone and cortisol responses to insulin-induced hypoglycemia were similar but prolactin increment was less than that obtained by the peptide injection. ACTH increments from both tests were substantially less than those obtained by the overnight metyrapone test. We conclude that pituitary function can be effectively studied in normal subjects by the combination of a metyrapone test with a triple bolus of growth hormone-, thytropin- and gonadotropin-releasing hormones, but not by a quadruple bolus of the hypothalamic peptides. Compared with insulin-induced hypoglycemia, this approach yields more information with fewer side effects.
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PMID:Quadruple injection of hypothalamic peptides to evaluate pituitary function in normal subjects. 391 7

Calcitonin gene-related peptide (CGRP) is a recently discovered widespread regulatory peptide which is encoded in the same gene as calcitonin. We assessed the effect of systemic infusion of synthetic rat CGRP at low dose (range 0.32-2.56 pmol/kg per min) on submaximal pentagastrin-stimulated gastric secretion and on gastrointestinal hormones. To assess its pharmacokinetic parameters in man the MCR and plasma half-life were estimated by the continuous infusion method. Gastric acid output and pepsin secretion were significantly reduced by CGRP (-29% of basal, P less than 0.01 and -40% of basal, P less than 0.005, respectively). There was a significant fall in basal levels of gastrin (-39%, P less than 0.001); gastric inhibitory peptide (-44.7%, P less than 0.001); enteroglucagon (-25%, P less than 0.001) and neurotensin (-33%, P less than 0.05). There was no significant change in plasma levels of insulin, motilin, pancreatic polypeptide or glucose. Suppression of gastric secretion and the fall in gastrointestinal hormones was prolonged and basal levels were not re-established after stopping the CGRP infusion. The disappearance curve of immunoreactive CGRP from the plasma was bi-exponential. The plasma half-life of immunoreactive CGRP was calculated as 6.9 +/- 0.9 min for the fast decay and 26.4 +/- 4.7 min for the slow decay. The calculated MCR was 11.3 +/- 1.2 ml/kg per min. Except for flushing of the face no untoward effects were observed. The results of this study suggest the possibility that CGRP could play a role in the regulation of gastric secretion and gastrointestinal hormone release.
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PMID:Infusion of a novel peptide, calcitonin gene-related peptide (CGRP) in man. Pharmacokinetics and effects on gastric acid secretion and on gastrointestinal hormones. 392 13

Among 53 patients with noninsulin-dependent diabetes (NIDD), chlorpropamide alcohol flushing (CPAF) was more prevalent than among 18 patients with insulin-dependent diabetes (64 vs. 28%, respectively). Among the former, chronic users of chlorpropamide (CP) had a higher prevalence of CPAF than those challenged once with the drug (86 vs. 56%, respectively). Serum CP concentrations were much higher in CP-treated patients, but levels were not different in CPAF-positive compared with CPAF-negative subjects, regardless of the length of their exposure to the drug. Our data confirm the association between CPAF and NIDD in a Jewish Israeli diabetic population and the effect of serum CP levels on the prevalence of this phenomenon.
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PMID:Prevalence of chlorpropamide alcohol flush in Jewish Israeli diabetics. The role of serum chlorpropamide concentrations. 398 Jan 99

This study evaluated the effect of gastric bypass on the glucose, insulin, vasoactive intestinal peptide (VIP), neurotensin, and motilin response to orally administered glucose in eight morbidly obese patients before and after operation. Preoperatively, all eight patients remained asymptomatic during an oral glucose tolerance test, which showed glucose intolerance and hyperinsulinism. Plasma VIP, neurotensin, and motilin remained below detectable levels for the entire test. At three months following gastric bypass (21% weight loss), all eight patients became acutely ill during a repeated oral glucose tolerance test and had the following symptoms: facial flushing (eight patients), palpitations (eight patients), nausea (seven patients), abdominal fullness (seven patients), pallor (four patients), diaphoresis (two patients), vomiting (two patients), and diarrhea (two patients). Significant release of neurotensin occurred in seven patients while three patients had release of VIP, further implicating these two peptides as part of the pathophysiologic spectrum of the "dumping syndrome."
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PMID:Neurotensin, vasoactive intestinal peptide, and Roux-en-Y gastrojejunostomy. Their role in the dumping syndrome. 398

Objective methods to study the chlorpropamide alcohol flush (CPAF) have been inadequate. Determination of blood acetaldehyde has proved to be a promising method, but the analysis is difficult and time-consuming. To measure the facial skin temperature is more handy. The results of these measurements can be presented as delta T (skin temperature increase), %T (per cent of maximum possible temperature rise) or delta MTCI (malar thermal circulation index) after calculations. The baseline skin temperature is accounted for in %T and delta MTCI. Blood acetaldehyde determinations and placebo-alcohol tests can be used to separate the CPAF reaction from alcohol flushing. Single dose CPAF tests including facial skin temperature measurements were performed in 133 type 2 (non-insulin dependent) diabetics. Facial flush was observed in 42.9%. The specificity and sensitivity of all three skin temperature methods were high: 88.2, 85.5, 96.1%, and 89.5, 86.0, 86.0%, respectively. Skin temperature measurement, whether expressed as delta T, %T or delta MTCI, provides a method to study CPAF with high accuracy.
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PMID:Facial skin temperature in chlorpropamide alcohol flush. 399 36

The rates of glucose production and utilization can be estimated by a primed-constant infusion technique using separate catheters for the infusion of radiolabelled glucose and periodic blood withdrawal. In rats, a carotid artery catheter is most often combined with a jugular or femoral venous catheter in such studies. We presently describe a method which utilizes a single jugular catheter for both infusion and sampling in the awake rat. This method is directly compared with simultaneous carotid artery sampling during both the dynamic steady state and a nonsteady state induced by a constant infusion of insulin. Our results demonstrate the validity of a single vein design for the analysis of glucose kinetics in either state. Rapid sampling and complete flushing prevent disruption of infusate equilibrium and sample contamination respectively. This single catheter method requires less technical skill for placement, reduces surgical intervention and enhances the comfort of the awake rat.
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PMID:The analysis of glucose kinetics using a single jugular catheter in awake rats. 399 22

A clinical and metabolic study of 32 patients treated with glibenclamide for a period of about one year confirmed that the drug is a potent stimulator of insulin release in maturity onset diabetes, and glibenclamide continued to have this action after a period of eight months. The drug is effective in doses as low as 2.5 mg., and the maximum effective dose is about 15 mg. No significant side-effects were found during the period of the study, in particular there was no alcohol flushing. The metabolic investigations have shown that the drug has some actions which are as yet unexplained.
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PMID:Clinical and metabolic study in diabetic patients treated with glibenclamide. 552 11

Chlorpropamide/alcohol flushing (CPAF), found in many patients with non-insulin-dependent diabetes (NIDD), can be blocked by indomethacin in most patients who are free of vascular complications but not in those with such complications. Since indomethacin is a prostaglandin inhibitor this finding suggests that prostaglandins may be involved in the aetiology of vascular diseases in NIDD. All 6 pairs of identical twins with CPAF, of whom 2 pairs were disocrdant for diabetes, were concordant for indomethacin blocking, which suggests that the block has a genetic basis. The difference in the response of CPAF to indomethacin in diabetic patients with and without vascular complications is probably the first indication of a metabolic difference between these two types of patient.
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PMID:Blockade of chlorpropamide-alcohol flushing by indomethacin suggests an association between prostaglandins and diabetic vascular complications. 610 37


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