All diseases of the digestive system are associated with deterioration of motor function and evacuation functions of the small and large intestine, stomach and esophagus. This problem is particularly relevant for functional dyspepsia, biliary dyskinesia and gastroesophageal reflux disease. In the treatment of such pathologies prokinetics of a new generation are used - medicines that allow to restore normal functioning of the gastrointestinal tract.
Modern prokinetics
Prokinetic properties are possessed by many chemical compounds, including hormonal peptides, macrolide-type antibiotics and opiate receptor antagonists. But we should prefer drugs that perform the following functions:
- an increase in the tone of the lower esophageal sphincter;
- improvement of esophageal cleansing;
- increased gastric motility;
- decrease in the number of esophageal refluxes and the time of contact of the mucosa of the esophagus with the contents of the stomach;
- elimination of delayed evacuation of gastric contents.
Today, the prokinetic group is mainly used, affecting the operation of the upper gastrointestinal tract:
- itopride;
- metoclopramide;
- cisapride;
- domperidone.
Let us consider them in more detail.
Which prokinetics are better?
Itopride or itopride hydrochloride is an active substance that produces two simultaneous effects:
- increase in the release of acetylcholine molecules;
- stimulation of muscarinic receptors.
Advantages of tiotropium is its positive effect on the esophageal sphincter, increasing the tone of the gallbladder and the motor activity of the muscles of the thick and small intestine. Thus, drugs based on the presented substance can be used in the syndrome of irritation of the intestine in combination with functional dyspepsia and constipation. Moreover, the compound significantly improves the contractile movements in the antrum part of the stomach, promotes the disappearance of duodenogastric reflux and produces an antiemetic effect.
Prokinetics of the new generation on the basis of ticopride:
- Ganaton;
- Itomed;
- Primer.
They are available in tablets with the same active ingredient dosage of 50 mg.
The next line of drugs is metoclopramide. This group of drugs has a very high efficiency due to several prokinetic mechanisms being performed, one of which is a direct intensification of contractions of the smooth muscles of the digestive tube.
It is worth noting that metoclopramides are prescribed only in cases where a short course of therapy is required with the need to achieve results as quickly as possible. This is due to the presence of a large number of adverse side effects. Among representatives of this group we note:
- Raglan;
- Cried.
Cisapride is considered one of the most effective medications of the type described. Their special feature is the activation of a new type of serotonin receptors, which are localized in the plexuses of the neurons of the stomach, esophagus and intestine. The medicines of this group include:
- Coordination;
- Prepulsed.
At the same time, cisaprial prokinetics in tablets provoke the development of serious side effects from the cardiovascular
The most popular and affordable drug of the described group is domperidone (Motilium). Its therapeutic effectiveness does not exceed the efficacy of metoclopramide, but it does not cause negative effects. The only drawback of Motilium is manifested with prolonged courses of reception in the form of increasing the level of the hormone prolactin.
The best prokinetic
Taking into account all the above-described properties of modern prokinetic medicines, it can be concluded that the most preferable drugs are the funds based on itopride.