Summary
This study primarily examines the role of the autonomic nervous system in the aldosterone response to metoclopramide since there is conflicting evidence as to the involvement of a dopaminergic mechanism in this response.
Six normal male volunteers in metabolic balance at 100 mmol sodium/day and 60 mmol potassium/day constant intake received metoclopramide, 10 mg i.v., on five different occasions. The dosing was either metoclopramide alone or combined with ganglionic, muscarinic, β-adrenergic or calcium-channel blockade.
Metoclopramide increased serum aldosterone significantly to 163.3% of basal level at 10 min. Atropine blunted this response and the 10 min level was significantly reduced to 116.03% of the basal value. The highest aldosterone levels were attained when metoclopramide was administered during a trimethaphan infusion and a peak of 292.8% of basal level occurred at 90 min. In the presence of atenolol, with or without nifedipine, the metoclopramide-induced aldosterone response was significantly greater at 15 min than with metoclopramide alone.
The results of this investigation suggest that the aldosterone response to metoclopramide is mediated by acetylcholine released from post-ganglionic cholinergic nerve terminals, and that an adrenergic mechanism exerts a tonic inhibitory influence on aldosterone secretion in man.
Similar content being viewed by others
References
Aguilera G, Mendelsohn FAO, Catt KJ (1984) Dopaminergic regulation of aldosterone secretion. In: Martini L, Ganong WF (eds) Frontiers in neuroendocrinology, voll 8. Raven Press, New York, pp 265–293
Carey RM, Thorner MO, Ortt EM (1979) Effect of metoclopramide and bromocriptine on the renin-angiotensin-aldosterone system in man: Dopaminergic control of aldosterone. J Clin Invest 63: 727–735
Carey RM, Thorner MO, Ortt EM (1980) Dopaminergic inhibition of metoclopramide-induced aldosterone secretion in man: Dissociation of responses to dopamine and bromocriptine. J Clin Invest 66: 10–18
Dupont AG, Vanderniepen P, Smitz JJ, Six RO (1985) Stimulation of aldosterone secretion by metoclopramide is not affected by chronic converting enzyme inhibition. Eur J Clin Pharmacol 29: 207–210
Eisner M (1968) Gastrointestinal effects of metoclopramide in man: In vitro experiments with human smooth muscle preparations. Br Med J 4: 679–680
Gordon MB, Moore TJ, Dluhy RG, Williams GH (1983) Dopaminergic blockade of the renin-angiotensin-aldosterone system: Effect of high and low sodium intakes. Clin Endocrinol 19: 415–425
Hay AM (1977) Pharmacological analysis of the effects of metoclopramide on the guinea pig isolated stomach. Gastroenterology 72: 864–869
Jungmann E, Althoff PH, Hermann GT, Schöffling K (1985) No effect of pizotifen, a serotonin antagonist and of pirenzepine, a muscarinic receptor blocker, on aldosterone stimulation by metoclopramide, hyperkalaemia and frusemide. J Hypertension 3: 412–413
Lun S, Espiner EA, Nicholls MG, Hart DS (1983) Lack of direct effect of dopamine on aldosterone secretion in vivo. Endocrinology 112: 60–63
Norbiato G, Bevilacqua M, Raggi U, Micossi P, Moroni C (1977) Metoclopramide increases plasma aldosterone in man. J Clin Endocrinol Metab 45: 1313–1316
Pratt JH, Ganguly AG, Parkinson CA, Weinberger MH (1981) Stimulation of aldosterone secretion by metoclopramide in humans: Apparent independence of renal and pituitary mediation. Metabolism 30: 129–134
Rolandi E, Marchetti G, Franceschini R, Cicchetti V, Gianrossi R, Cantoni V, Barreca T (1986) Inhibition of prolactin and aldosterone secretion by the dopamine derivative ibopamine. Eur J Clin Pharmacol 29: 629–630
Sowers JR (1984) Dopamine regulation of renin and aldosterone secretion: A review. J Hypertension 2 [Suppl 1]: 67–73
Watson M, Vickroy TW, Roeske WR, Yamamura HI (1984) Subclassification of muscarinic receptors based upon the selective antagonist pirenzepine. Trends pharmacol Sci 6 [Suppl]: 9–11
Wilson TA, Kaiser DL, Carey RM (1983) Dopaminergic inhibition of aldosterone secretion in man is independent of the autonomic nervous system. J Clin Endocrinol Metab 57: 200–203
Wright RD, Blair-West JR, Coghlan JP, Denton DA, Funder JW, Goding JR, Nelson JF, Scoggins BA (1972) The structure and function of adrenal autotransplants. Aust J Exp Biol Med Sci 50: 873–892
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
De Sommers, K., Meyer, E.C., van Wyk, M. et al. Aldosterone response to metoclopramide is mediated through the autonomic nervous system in man. Eur J Clin Pharmacol 33, 609–612 (1988). https://doi.org/10.1007/BF00542496
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00542496