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• W55122992 abstract "No AccessJournal of Urology1 Jul 1985Chlorpromazine: Adjuvant Therapy for the Metabolic Derangements Created by Urinary Diversion through Intestinal Segments Michael O. Koch and W. Scott McDougal Michael O. KochMichael O. Koch More articles by this author and W. Scott McDougalW. Scott McDougal More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)47049-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The hyperchloremic metabolic acidosis which can occur following urinary diversion through intestinal segments has been managed with bicarbonate or citrate salts. However, satisfactory management is not always possible with this form of treatment. The development of this acidosis has been attributed to intestinal reabsorption of urinary solutes or intestinal secretion of bicarbonate. Intestinal absorptive and secretory processes are modulated by an adenylate cyclase-cyclic AMP system. Chlorpromazine inhibits the effect of cyclic AMP on the intestinal mucosal cell. The use of chlorpromazine in the management of the hyperchloremic metabolic acidosis following urinary diversion was investigated. A canine model employing an ileal segment between ureter and bladder and a rat model in which urine is diverted through the entire colon have been developed. Chlorpromazine (5mg./kg./day) was found to be efficacious in the management of the metabolic derangements that occur in both of these models. A case study is presented in which conventional management of this syndrome with bicarbonate salts was unsuccessful. The use of chlorpromazine as an adjuvant treatment allowed correction of the acidosis. © 1985 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGILBERT S and HENSLE T (2018) METABOLIC CONSEQUENCES AND LONG-TERM COMPLICATIONS OF ENTEROCYSTOPLASTY IN CHILDREN: A REVIEWJournal of Urology, VOL. 173, NO. 4, (1080-1086), Online publication date: 1-Apr-2005.Kristjansson A, Davidsson T and Mansson W (2018) Metabolic Alterations at Different Levels of Renal Function Following Continent Urinary Diversion Through Colonic SegmentsJournal of Urology, VOL. 157, NO. 6, (2099-2103), Online publication date: 1-Jun-1997.Anderson K, Fadden P, Kerbl K, McDougall E and Clayman R (2018) Laparoscopic Assisted Continent Urinary Diversion in the PigJournal of Urology, VOL. 154, NO. 5, (1934-1938), Online publication date: 1-Nov-1995.McDougal W (2018) Metabolic Complications of Urinary Intestinal DiversionJournal of Urology, VOL. 147, NO. 5, (1199-1208), Online publication date: 1-May-1992.Koch M, Mcdougal W and Flora M (2018) Urease and the Acidosis of Urinary Intestinal DiversionJournal of Urology, VOL. 146, NO. 2 Part 1, (458-462), Online publication date: 1-Aug-1991.Miller K, Matsui U and Hautmann R (2018) The Functional Rectal Bladder-Prevention of Hyperchloremic Acidosis Following Vesico-Sigmoidostomy in DogsJournal of Urology, VOL. 144, NO. 2 Part 1, (375-380), Online publication date: 1-Aug-1990.Graversen P, Gasser T, Friedman A and Bruskewitz R (2018) Surveillance of Long-Term Metabolic Changes after Urinary DiversionJournal of Urology, VOL. 140, NO. 4, (818-819), Online publication date: 1-Oct-1988.Mohler J (2018) Metabolic Acidosis After Bladder Replacement: Comparison of Severity and Reversibility in Ileal and Colonic ReservoirsJournal of Urology, VOL. 139, NO. 3, (628-633), Online publication date: 1-Mar-1988.Piser J, Mitchell M, Kulb T, Rink R, Kennedy H and McNulty A (2018) Gastrocystoplasty and Colocystoplasty in Canines: The Metabolic Consequences of Acute Saline and Acid LoadingJournal of Urology, VOL. 138, NO. 4 Part 2, (1009-1013), Online publication date: 1-Oct-1987.McDougal W (2018) Bladder Reconstruction Following Cystectomy by Uretero-Ileo-ColourethrostomyJournal of Urology, VOL. 135, NO. 4, (698-701), Online publication date: 1-Apr-1986.Zinman L (2018) Editorial CommentJournal of Urology, VOL. 135, NO. 4, (701-701), Online publication date: 1-Apr-1986.Koch M and McDougal W (2018) Nicotinic Acid: Treatment for the Hyperchloremic Acidosis Following Urinary Diversion through Intestinal SegmentsJournal of Urology, VOL. 134, NO. 1, (162-164), Online publication date: 1-Jul-1985. Volume 134Issue 1July 1985Page: 165-169 Advertisement Copyright & Permissions© 1985 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Michael O. Koch More articles by this author W. Scott McDougal More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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