이독성 항생물질이 위액분비 및 실험적 위궤양에 미치는 영향

Abstract

[한글]

[영문]

Streptomycin was the first clinically effective drug to become available for the

treatment of tuberculosis but many investigators reported labyrinthine and

vestibular dysfunction including vertigo, tinnitus, ataxia and hearing loss in the

course of tuberculosis therapy with this drug.

Thereafter the other aminoglycosides such as neomycin, kanamycin and gentamicin,

and also polypeptides of this series, viomycin and capreomycin, were introduced.

Nevertheless, all of these drugs showed some degree of similar ototoxicity as it

seen in streptomycin. Studies on histopathological changes of inner ear revealed

that these antibiotics produced degeneration of internal and external hair cells,

and spiral ganglion cell in Corti's organ as well as changes of endolymph pressure

in scala media.

Moon (1971) reported the circular movement caused a decrease in gastric secretion

but failed to decrease after labyrinthectomy or streptomycin treatment. Schapiro et

al (1970, 1971) reported visual deprivation or labyrinthectomy caused a marked

depression of gastric secretion and concluded that this might result from reduced

gastric vagal activity and therefore the parietal cells and the chief cells became

less sensitive.

Present study was undertaken to observe the effect of various ototoxic

antibiotics on the gastric secretory activity and gastric mucosa.

One hundred and fifty albino rats of both sexes weighing 200 gm around were

divided into two experimental groups.

Experiment 1: The following antibiotics, diluted into 10 ml of saline, was

injected i.p. 30 minutes prior to procedure: Streptomycin 400 mg/kg, neomycin 200

mg/kg, gentamicin 5 mg/kg or viomycin 100 mg/kg. Control animals were administered

either with saline (10 ml/kg) or penicillin(800,000 lU/kg). After ligation of

pylorus (Shay operation of the rat) gastric juice was collected for 6 hours.

Experiment 2 : The following antibiotics was injected daily for 1 week after same

preparation as experiment 1 : Streptomycin 200 mg/kg, neomycin 100 mg/kg,

gentamicin 2.5 mg/kg, capreomycin 200 mg/kg, or viomycin 50 mg/kg. After treatment

the pylorus of the stomach was ligated for 20 hours.

Acidity of gastric juice was determined by consumed amount of NaOH (mEq/L) by

means of Titrator TTT 2b with the end point of pH 3 and pH 8 on free acidity and

total acidity, respectively.

Gastric mucosal changes were observed with stereoscope.

The results obtained are summarized as follows :

1. Gastric secretion was significantly inhibited by the treatment with ototoxic

antibiotics, especially with neomycin and capreomycin. However with gentamicin the

gastric secretion was enhanced.

2. The pH of gastric juice was markedly increased in all groups especially in

neomycin and carpreomycin treated group.

3. The concentration of gastric acid was generally decreased, moreover, the free

acid in capreomycin treated group was only trace amount.

4. The mucosal changes of the stomach after one week treatment with ototoxic

antibiotics were seen on foregut only. The most severe mucosal damage was seen in

gentamicin and kanamycin groups but little damage in capreomycin group.

By these findings it may be suggested that the ototoxic antibiotics affect the

gastric secretion and gastric mucosa greatly and that the more toxic to the ear,

the less amount of gastric secretion and the less damage to the gastric mucosa.