Document Detail

Pharmacokinetic and clinical studies in patients with cimetidine-associated mental confusion.
MedLine Citation:
PMID:  84204     Owner:  NLM     Status:  MEDLINE    
15 cases of cimetidine-associated mental confusion have been reported. In order that this syndrome might be investigated changes in mental status (M.S.) were correlated with serum concentrations and renal and hepatic function in 36 patients, 30 patients had no M.S. change on cimetidine and 6 had moderate to severe changes. These 6 patients had both renal and liver dysfunction (P less than 0.05), as well as cimetidine trough-concentrations of more than 1.25 microgram/ml (P less than 0.05). The severity of M.S. changes increased as trough-concentrations rose, 5 patients had lumbar puncture. The cerebrospinal fluid: serum ratio of cimetidine concentrations was 0.24:1 and indicates that cimetidine passes the blood-brain barrier; it also raises the possibility that M.S. changes are due to blockade of histamine H2-receptors in the central nervous system. Patients likely to have both raised trough-concentrations and mental confusion are those with both severe renal and hepatic dysfunction. They should be closely observed and should be given reduced doses of cimetidine.
J J Schentag; F B Cerra; G Calleri; E DeGlopper; J Q Rose; H Bernhard
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Lancet     Volume:  1     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1979 Jan 
Date Detail:
Created Date:  1979-04-28     Completed Date:  1979-04-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  177-81     Citation Subset:  AIM; IM    
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MeSH Terms
Cimetidine / adverse effects*,  cerebrospinal fluid,  metabolism,  therapeutic use
Cognition Disorders / chemically induced*
Confusion / chemically induced*
Gastrointestinal Hemorrhage / drug therapy
Guanidines / adverse effects*
Kidney / drug effects*,  physiopathology
Liver / drug effects*,  physiopathology
Mental Processes / drug effects*,  physiology
Reg. No./Substance:
0/Guanidines; 51481-61-9/Cimetidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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