Prokinetics are medicines that belong to the group of gastrointestinal motility stimulants. An interesting fact is connected with them. The list of prokinetic drugs, which would be recognized by all gastroenterologists, does not exist. Different specialists differently define such a list. What are the prokinetics?
Prokinetic antagonists of dopamine receptors
The effect of prokinetic antagonists is based on the fact that they quickly bind to D2-dopamine receptors and significantly reduce their response to the natural signals of the human body. Thanks to this they help to activate the motor function of the stomach, as well as stimulate antiemetic action. The list of such prokinetic drugs includes:
- Bromopride;
- Domperidone;
- Metoclopramide;
- Dimetramipid.
Most often, all of them are used for the treatment of the gastrointestinal tract Domperidone, in spite of the fact that it is a prokinetic of the second generation. This is due to the fact that it does not have significant side effects.
Some experts refer to this group of antagonists and Itopride. But officially this is not recognized, since it has an inhibitory effect on acetylcholine. Also in this group of prokinetics are preparations of the first generation of Reglan and Cerukal. And all because of their active ingredient is metoclopramide. Under certain circumstances, can cause tachycardia, tinnitus, drowsiness and dizziness.
Prokinetic antagonists are used when:
- achalasia of the esophagus ;
- ulcer of the stomach or duodenum;
- cuts of the intestine, which occur after operations;
- flatulence;
- treatment of gastroesophageal reflux disease;
- functional dyspepsia;
- severe discenosis of bile ducts.
In rare cases, drugs that are part of this group can be prescribed for kidney and liver diseases, vomiting and nausea caused by infectious diseases, or with radiation therapy. They are often used to prevent vomiting before endoscopy or various radiopaque studies.
Prokinetics-stimulants of intestinal peristalsis
The most known prokinetics of this group are preparations bearing the names of Coordax and Mozapride. They are very similar in the method of action. They differ only in that Mozapride has practically no effect on potassium channel activity, and this significantly reduces the risk of cardiac rhythm disturbances.
This group also includes such drugs as:
- Aceclidine;
- Cerulety;
- Physiostigmine;
- Pyridostigmine bromide;
- Galantamine;
- Neostigmine monosulfate.
Prokinetics-agonists of motilin receptors
Prokinetic drugs also include drugs that bind to motilin receptors (a hormone that helps increase pressure in the lower esophageal sphincter, which contributes to emptying). These include:
- Azithromycin;
- Clarithromycin;
- Atilmotine;
- Erythromycin.
These drugs lead to quite strong peristaltic contractions. As a result, the stomach clears from liquid or solid food. Also, the time of passage of the contents in the large intestine considerably decreases, even in certain pathologies, for example, with diabetic gastroparesis or progressive systemic scleroderma.
If you have been prescribed prokinetic agonists for the motilin receptor, be careful because they have side effects. For example, Erythromycin, taken for more than a month, may increase the risk of death due to severe cardiac conduction abnormalities.