[Pharmacologic and clinical differentiation of prokinetic drugs].
In the treatment of gastrointestinal motility disorders 3 prokinetic agents are principally available. They are differentiated from their pharmacological mode of action, their clinical efficacy and tolerability. Metroclopramide is an antidopaminergic benzamide with mainly antiemetic effects and minor prokinetic efficacy in the GI-Tract. Domperidon is a pure dopaminantagonist. It accelerates gastric emptying but has less effect on bowel motility. Cisapride stimulates indirect the secretion of acetylcholine and acts via 5 HT-receptors selective at the plexus myentericus. These pharmacological differences have clinical relevance: metoclopramide and domperidon could not consistently prove efficacy in functional dyspepsia and GORD. In addition the data in other indications are rare. Only cisapride has shown significant responder rates in controlled studies in the treatment of gastrointestinal motility disorders particularly in long term treatment. As concerns tolerability cisapride presents a progress by its selective mode of action in contrast to the agents crossing the blood-brain-barrier.
May
B
B
Abteilung für Gastroenterologie und Hepatologie, Medizinische Klinik der Berufsgenossenschaftlichen Krankenanstalten Bergmannsheil Universitätsklinik, Bochum, Germany.
Greving
I
I
D000328:Adult; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D020117:Cisapride / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004294:Domperidone / Q000009:adverse effects / Q000627:therapeutic use*; D018492:Dopamine Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D004415:Dyspepsia / Q000188:drug therapy; D005746:Gastric Emptying / Q000187:drug effects; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008787:Metoclopramide / Q000009:adverse effects / Q000627:therapeutic use*; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy; D017366:Serotonin Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D000932:Antiemetics; D018492:Dopamine Antagonists; D010880:Piperidines; D017366:Serotonin Receptor Agonists; D004294:Domperidone; D008787:Metoclopramide; D020117:Cisapride
Zur pharmakologischen und klinischen Differenzierung von Prokinetika.