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Molecules (Basel, Switzerland) Apr 2019The antispasmodic effect of drugs is used for the symptomatic treatment of cramping and discomfort affecting smooth muscles from the gastrointestinal, billiary or... (Meta-Analysis)
Meta-Analysis Review
The antispasmodic effect of drugs is used for the symptomatic treatment of cramping and discomfort affecting smooth muscles from the gastrointestinal, billiary or genitourinary tract in a variety of clinical situations.The existing synthetic antispasmodic drugs may cause a series of unpleasant side effects, and therefore the discovery of new molecules of natural origin is an important goal for the pharmaceutical industry. This review describes a series of recent studies investigating the antispasmodic effect of essential oils from 39 plant species belonging to 12 families. The pharmacological models used in the studies together with the mechanistic discussions and the chemical composition of the essential oils are also detailed. The data clearly demonstrate the antispasmodic effect of the essential oils from the aromatic plant species studied. Further research is needed in order to ascertain the therapeutic importance of these findings.
Topics: Animals; Calcium Channel Blockers; Calcium Channels; Clinical Studies as Topic; Cyclic AMP; Drug Evaluation, Preclinical; Humans; Molecular Structure; Muscle Contraction; Muscle, Smooth; Oils, Volatile; Parasympatholytics; Phytochemicals; Plant Extracts; Structure-Activity Relationship; Treatment Outcome
PubMed: 31035694
DOI: 10.3390/molecules24091675 -
Oxidative Medicine and Cellular... 2021Numerous medicinal plants have been utilized for the treatment of different types of diseases and disorders including gastrointestinal (GI) diseases. GI diseases are the... (Review)
Review
Numerous medicinal plants have been utilized for the treatment of different types of diseases and disorders including gastrointestinal (GI) diseases. GI diseases are the most common complaints that normally affects the largest proportion of children and adolescents with overlapping clinical manifestation in diagnosis and medical needs. Drugs with antispasmodic effects are normally applied for the symptomatic treatment of contraction and cramping of smooth muscles in gastrointestinal diseases as well as in other critical clinical situations. In alternative system of medicines, the antispasmodic herbs played a significant role in the cure of GI diseases. These medicinal plants and their herbal products are used from generation to generation because of multiple nutritional and therapeutic benefits. The multiple uses might be attributed to the presence on biologically active chemical constitutes. The main aim of this review is to focus on the medicinal potential of plants possessing antispasmodic activities with their proposed mechanism of action. Several databases such as Google Scholar, Cochrane database, Scopus, and PubMed were used to search the relevant literature regarding "plants with antispasmodic activities." This present study highlights the updated and quantified information on several medicinal plants with antispasmodic activity like , , , , , , , , and . Moreover, recent studies on other medicinal plant species also have been included in this review article. Additionally, the study also revealed that the active compounds of all these plants possess significant spasmolytic effect which is safest, efficacious, and cost effective as compared to the available synthetic drugs.
Topics: Animals; Autonomic Nervous System Diseases; Humans; Parasympatholytics; Phytochemicals; Phytotherapy; Plants, Medicinal
PubMed: 34804367
DOI: 10.1155/2021/4889719 -
Gastroenterology Jul 2022Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction associated with significant disease burden. This American Gastroenterological Association...
BACKGROUND & AIMS
Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction associated with significant disease burden. This American Gastroenterological Association guideline is intended to support practitioners in decisions about the use of medications for the pharmacological management of IBS-C and is an update of a prior technical review and guideline.
METHODS
The Grading of Recommendations Assessment, Development and Evaluation framework was used to assess evidence and make recommendations. The technical review panel prioritized clinical questions and outcomes according to their importance for clinicians and patients and conducted an evidence review of the following agents: tenapanor, plecanatide, linaclotide, tegaserod, lubiprostone, polyethylene glycol laxatives, tricyclic antidepressants, selective serotonin reuptake inhibitors, and antispasmodics. The Guideline Panel reviewed the evidence and used the Evidence-to-Decision Framework to develop recommendations.
CONCLUSIONS
The panel agreed on 9 recommendations for the management of patients with IBS-C. The panel made a strong recommendation for linaclotide (high certainty) and conditional recommendations for tenapanor, plecanatide, tegaserod, and lubiprostone (moderate certainty), polyethylene glycol laxatives, tricyclic antidepressants, and antispasmodics (low certainty). The panel made a conditional recommendation against the use of selective serotonin reuptake inhibitors (low certainty).
Topics: Antidepressive Agents, Tricyclic; Constipation; Gastrointestinal Agents; Humans; Irritable Bowel Syndrome; Laxatives; Lubiprostone; Parasympatholytics; Polyethylene Glycols; Selective Serotonin Reuptake Inhibitors
PubMed: 35738724
DOI: 10.1053/j.gastro.2022.04.016 -
Molecules (Basel, Switzerland) Oct 2023, belonging to the family Apocynaceae, is one of the best-known medicinal plants in Africa and Asia. Stem back preparations are traditionally used as muscle relaxants....
BACKGROUND
, belonging to the family Apocynaceae, is one of the best-known medicinal plants in Africa and Asia. Stem back preparations are traditionally used as muscle relaxants. This study investigated the antispasmodic properties of Stem back and its constituents.
METHOD
The freeze-dried aqueous Stem back extract of , as well as dichloromethane (DCM), ethyl acetate, and aqueous fractions, were evaluated for their antispasmodic effect via the ex vivo method. Two compounds were isolated from the DCM fraction using chromatographic techniques, and their antispasmodic activity was evaluated. An in silico study was conducted by evaluating the interaction of isolated compounds with human PPARgamma-LBD and human carbonic anhydrase isozyme.
RESULTS
The Stem back crude extract, DCM, ethyl acetate, and aqueous fractions showed antispasmodic activity on high-potassium-induced (K 80 mM) contractions on isolated rat ileum with IC values of 0.03 ± 0.20, 0.02 ± 0.05, 0.03 ± 0.14, and 0.90 ± 0.06 mg/mL, respectively. The isolated compounds from the DCM fraction were β-amyrin and boonein, with only boonein exhibiting antispasmodic activity on both high-potassium-induced (IC = 0.09 ± 0.01 µg/mL) and spontaneous (0.29 ± 0.05 µg/mL) contractions. However, β-amyrin had a stronger interaction with the two proteins during the simulation.
CONCLUSION
The isolated compounds boonein and β-amyrin could serve as starting materials for the development of antispasmodic drugs.
Topics: Rats; Animals; Humans; Alstonia; Plant Extracts; Parasympatholytics; Water; Potassium
PubMed: 37894548
DOI: 10.3390/molecules28207069 -
The American Journal of Gastroenterology Aug 2021Chronic abdominal pain is a common gastrointestinal (GI) symptom that characterizes many functional GI disorders/disorders of gut-brain interaction, including irritable... (Review)
Review
Chronic abdominal pain is a common gastrointestinal (GI) symptom that characterizes many functional GI disorders/disorders of gut-brain interaction, including irritable bowel syndrome, functional dyspepsia, and centrally mediated abdominal pain syndrome. The symptoms of abdominal pain in these highly prevalent disorders are often treated with antispasmodic agents. Antispasmodic treatment includes a broad range of therapeutic classes with different mechanisms of action, including anticholinergic/antimuscarinic agents (inhibition of GI smooth muscle contraction), calcium channel inhibitors (inhibition of calcium transport into GI smooth muscle), and direct smooth muscle relaxants (inhibition of sodium and calcium transport). The aim of this review article was to examine the efficacy and safety of antispasmodics available in North America (e.g., alverine, dicyclomine, hyoscine, hyoscyamine, mebeverine, otilonium, pinaverium, and trimebutine) for the treatment of chronic abdominal pain in patients with common disorders of gut-brain interaction. For the agents examined, comparisons of studies are limited by inconsistencies in treatment dosing and duration, patient profiles, and diagnostic criteria employed. Furthermore, variability in study end points limits comparisons. Risk of selection, performance, detection, attrition, and reporting bias also differed among studies, and in many cases, risks were considered "unclear." The antispasmodics evaluated in this review, which differ in geographic availability, were found to vary dramatically in efficacy and safety. Given these caveats, each agent should be considered on an individual basis, rather than prescribed based on information across the broad class of agents.
Topics: Abdominal Pain; Chronic Pain; Humans; North America; Parasympatholytics
PubMed: 33993133
DOI: 10.14309/ajg.0000000000001266 -
AJR. American Journal of Roentgenology Jun 1994In 1958, Welin recommended the routine use of atropine before a barium enema to reduce mucus secretion and make the examination more comfortable. Currently, many... (Review)
Review
In 1958, Welin recommended the routine use of atropine before a barium enema to reduce mucus secretion and make the examination more comfortable. Currently, many radiologists believe that smooth-muscle spasmolysis is a useful adjunct during a barium enema and use such a spasmolytic agent. One survey found that spasmolytic agents were administered more frequently in 1987 than in 1976. The use of glucagon had increased 20% between 1976 and 1987. Among 34 foreign institutions responding to the survey, 37% used glucagon and 45% used scopolamine butylbromide (Buscopan). Nevertheless, it is still controversial whether spasmolytic agents play a significant role in the performance and interpretation of a barium enema. Some radiologists routinely use a spasmolytic agent; others do so only selectively.
Topics: Aged; Atropine; Barium Sulfate; Drug Utilization; Enema; Glucagon; Humans; Parasympatholytics
PubMed: 8191992
DOI: 10.2214/ajr.162.6.8191992 -
Revista de Gastroenterologia de Mexico 2012Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit.
AIMS
To determine the clinical effectiveness of the antispasmodic agents available in Mexico for the treatment of IBS.
METHODS
We carried out a systematic review and meta-analysis of randomized controlled clinical trials on antispasmodic agents for IBS treatment. Clinical trials identified from January 1960 to May 2011 were searched for in MEDLINE, the Cochrane Library, and in the ClinicalTrials.gov registry. Treatment response was evaluated by global improvement of symptoms or abdominal pain, abdominal distention/bloating, and frequency of adverse events. The effect of antispasmodics vs placebo was expressed in OR and 95% CI.
RESULTS
Twenty-seven studies were identified, 23 of which fulfilled inclusion criteria. The studied agents were pinaverium bromide, mebeverine, otilonium, trimebutine, alverine, hyoscine, alverine/simethicone, pinaverium/simethicone, fenoverine, and dicyclomine. A total of 2585 patients were included in the meta-analysis. Global improvement was 1.55 (CI 95%: 1.33 to 1.83). Otilonium and the alverine/simethicone combination produced significant values in global improvement while the pinaverium/simethicone combination showed improvement in bloating. As for pain, 2394 patients were included with an OR of 1.52 (IC 95%: 1.28 a 1.80), favoring antispasmodics.
CONCLUSIONS
Antispasmodics were more effective than placebo in IBS, without any significant adverse events. The addition of simethicone improved the properties of the antispasmodic agents, as seen with the alverine/simethicone and pinaverium/simethicone combinations.
Topics: Drug Therapy, Combination; Humans; Irritable Bowel Syndrome; Parasympatholytics; Randomized Controlled Trials as Topic
PubMed: 22672854
DOI: 10.1016/j.rgmx.2012.04.002 -
International Journal of Clinical... 1985The pharmacology and clinical use of cimetropium bromide is reviewed. Experimental and clinical data demonstrated that this new compound is a potent antimuscarinic and... (Review)
Review
The pharmacology and clinical use of cimetropium bromide is reviewed. Experimental and clinical data demonstrated that this new compound is a potent antimuscarinic and an effective antispasmodic drug. It is also endowed of a direct myolitic action which partially accounts for its antispasmodic activity. Clinical trials as yet performed confirmed its efficacy in many painful conditions of the gastrointestinal, biliary and genitourinary tracts, as well as its usefulness as a pre-endoscopic medication. Finally, the drug proved to be well tolerated, with a low incidence of atropine-like untoward effects.
Topics: Animals; Anti-Ulcer Agents; Atropine; Gastric Mucosa; Gastrointestinal Motility; Hemodynamics; Humans; Kinetics; Muscle Contraction; Parasympatholytics; Pupil; Salivation; Scopolamine Derivatives
PubMed: 3912339
DOI: No ID Found -
Molecules (Basel, Switzerland) Sep 2021Antispasmodic agents are used for modulating gastrointestinal motility. Several compounds isolated from terrestrial plants have antispasmodic properties. This study...
Antispasmodic agents are used for modulating gastrointestinal motility. Several compounds isolated from terrestrial plants have antispasmodic properties. This study aimed to explore the inhibitory effect of the pyrrolidine derivative, asperidine B, isolated from the soil-derived fungus PSU-RSPG178, on spasmodic activity. Isolated rat ileum was set up in an organ bath. The contractile responses of asperidine B (0.3 to 30 µM) on potassium chloride and acetylcholine-induced contractions were recorded. To investigate its antispasmodic mechanism, CaCl, acetylcholine, Nω-nitro-l-arginine methyl ester (l-NAME), nifedipine, methylene blue and tetraethylammonium chloride (TEA) were tested in the absence or in the presence of asperidine B. Cumulative concentrations of asperidine B reduced the ileal contraction by ~37%. The calcium chloride and acetylcholine-induced ileal contraction was suppressed by asperidine B. The effects of asperidine B combined with nifedipine, atropine or TEA were similar to those treated with nifedipine, atropine or TEA, respectively. In contrast, in the presence of l-NAME and methylene blue, the antispasmodic effect of asperidine B was unaltered. These results suggest that the antispasmodic property of asperidine B is probably due to the blockage of the L-type Ca channel and is associated with K channels and muscarinic receptor, possibly by affecting non-selective cation channels and/or releasing intracellular calcium.
Topics: Acetylcholine; Animals; Calcium; Calcium Channel Blockers; Calcium Channels, L-Type; Cyclic GMP; Ileum; Male; Methylene Blue; Muscle Contraction; Muscle, Smooth; NG-Nitroarginine Methyl Ester; Parasympatholytics; Potassium Chloride; Pyrrolidines; Rats, Wistar; Tetraethylammonium; Rats
PubMed: 34576962
DOI: 10.3390/molecules26185492 -
Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis.Journal of Clinical Gastroenterology Jul 2014The aim of this study was to assess the efficacy and safety of enteric-coated peppermint oil capsules compared with placebo for the treatment of active irritable bowel... (Meta-Analysis)
Meta-Analysis Review
GOALS
The aim of this study was to assess the efficacy and safety of enteric-coated peppermint oil capsules compared with placebo for the treatment of active irritable bowel syndrome (IBS).
BACKGROUND
IBS is a common disorder that is often encountered in clinical practice. Medical interventions are limited and the focus is on symptom control.
STUDY
Randomized placebo-controlled trials with a minimum treatment duration of 2 weeks were considered for inclusion. Cross-over studies that provided outcome data before the first cross-over were included. A literature search upto February 2013 identified all applicable randomized-controlled trials. Study quality was evaluated using the Cochrane risk of bias tool. Outcomes included global improvement of IBS symptoms, improvement in abdominal pain, and adverse events. Outcomes were analyzed using an intention-to-treat approach.
RESULTS
Nine studies that evaluated 726 patients were identified. The risk of bias was low for most of the factors assessed. Peppermint oil was found to be significantly superior to placebo for global improvement of IBS symptoms (5 studies, 392 patients, relative risk 2.23; 95% confidence interval, 1.78-2.81) and improvement in abdominal pain (5 studies, 357 patients, relative risk 2.14; 95% confidence interval, 1.64-2.79). Although peppermint oil patients were significantly more likely to experience an adverse event, such events were mild and transient in nature. The most commonly reported adverse event was heartburn.
CONCLUSIONS
Peppermint oil is a safe and effective short-term treatment for IBS. Future studies should assess the long-term efficacy and safety of peppermint oil and its efficacy relative to other IBS treatments including antidepressants and antispasmodic drugs.
Topics: Abdominal Pain; Capsules; Humans; Irritable Bowel Syndrome; Mentha piperita; Parasympatholytics; Plant Oils; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 24100754
DOI: 10.1097/MCG.0b013e3182a88357