Prokinetic

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Definition

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 intestine or 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.

Pharmacokinetics

Both cisapride and metoclopramide are serotonin receptor modulators.

Cisapride acts on 5HT4 receptor. Its metabolised by CYP3A4 so when combined with enzyme inhibitors as ketoconazole, erythromycin the increased serum level can produce prolonged QT interval in ECG and serious cardiac arrythmia.

Parasympathomimetics as bethanechol. They increase motility and secretions as well as motilin like agents e.g. erythromycin.

Examples

Examples of this class of drug are:

• Domperidone
• Metoclopramide
• Cisapride

Further reading

• 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.