Prokinetics are a class of drugs used on the
digestive system. It includes all drugs whose primary effect is to augment the speed of intestinal transit, by increasing the frequency of contractions in the small intestineor making them stronger, but without disrupting their rhythm. They are mostly used to treat or prevent pathological gastroesophageal reflux, or to speed up absorption of certain other drugs. Some of them can also be used to help in the treatment of nausea or other symptoms associated with dyspepsia.Most of these drugs are grouped under ATC code A03F.
cisaprideand metoclopramideare serotonin receptormodulators.
Cisapride acts on
5HT4 receptor. Its metabolised by CYP3A4so when combined with enzyme inhibitors as ketoconazole, erythromycinthe increased serum level can produce prolonged QT intervalin ECGand serious cardiac arrythmia. Parasympathomimetics as bethanechol. They increase motility and secretions as well as motilin like agents e.g. erythromycin.
Examples of this class of drug are:
Cisaprideonly approved agent in this class
* Hardman JG, Limbird LE, Gilman AG. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 10th ed. New York: McGraw-Hill, 2001. ISBN 0-07-135469-7.
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