The effect of cisapride and metoclopramide on human digestive and interdigestive antroduodenal motility.
BACKGROUND
To date, there is little information available about the effect of cisapride and metoclopramide on gastroduodenal pressure waves and their space/time orientation.


METHODS
Antroduodenal pressures (two antral, three duodenal recording sites) were measured in nine healthy volunteers. Cisapride (10 mg), metoclopramide (10 mg), and placebo were administered intravenously on different days in a randomized manner.


RESULTS
During the interdigestive state cisapride increased the motility index significantly in the antrum (p < 0.05) and duodenum (p < 0.005), metoclopramide only in the duodenum (p < 0.01). Antroduodenal coordination was significantly (p < 0.01) improved by cisapride but not by metoclopramide. There is evidence of antroduodenal coordination even during the interdigestive state. After a liquid test meal an increase in the antroduodenal motility index (p < 0.05), in the rate of prograde antroduodenal peristalsis (p < 0.01), and in antroduodenal coordination (p < 0.01) was caused by cisapride but not metoclopramide. Both prokinetics decreased (p < 0.01) retrograde antroduodenal peristalsis.


CONCLUSIONS
Cisapride significantly improves antroduodenal coordination and antroduodenal motility; metoclopramide seems to be less effective.
Lux
G
G
Dept. of Medicine, Clinic A, University of Erlangen-Nuremberg, Germany.
Katschinski
M
M
Ludwig
S
S
Lederer
P
P
Ellermann
A
A
Domschke
W
W
D000328:Adult; D020117:Cisapride; D004063:Digestion / Q000187:drug effects / Q000502:physiology; D004311:Double-Blind Method; D004386:Duodenum / Q000187:drug effects / Q000502:physiology; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008365:Manometry; D008787:Metoclopramide / Q000008:administration & dosage / Q000494:pharmacology*; D010880:Piperidines / Q000008:administration & dosage / Q000494:pharmacology*; D011706:Pyloric Antrum / Q000187:drug effects / Q000502:physiology; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000494:pharmacology*
D010880:Piperidines; D012702:Serotonin Antagonists; D008787:Metoclopramide; D020117:Cisapride