title: Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study.
abstract: OBJECTIVE
  Tegaserod may enhance upper gut transit, but, its prokinetic effects on antral/small bowel motility and how this compares with erythromycin is unknown. We prospectively assessed and compared the effects of tegaserod and erythromycin on upper gut motility.
  
  
  METHODS
  In an open label, non-crossover study, 22 patients (M/F=4/18; mean age=37 years) with symptoms of upper gut dysmotility underwent 24-hour ambulatory antroduodenojejunal manometry with a six-sensor solid state probe. The effects of 12 mg oral tegaserod were compared with 125 mg intravenous erythromycin by quantifying pressure wave activity and assessing motor patterns.
  
  
  RESULTS
  Motor activity increased (p<0.05) in antrum, duodenum and jejunum with both drugs when compared to baseline period. The motor response with tegaserod was higher (p<0.05) in jejunum and occurred during the second or third hours, whereas with erythromycin, it was higher (p<0.05) in antrum and occurred within 30 minutes. After tegaserod, a 'fed-response' like pattern was seen whereas after erythromycin, large amplitude (>100 mmHg) antral contractions at 3 cycles per minute were seen. Following tegaserod and erythromycin, phase III MMCs occurred in 12 (55%) and 8 (36%) patients respectively (p>0.05).
  
  
  CONCLUSIONS
  Both drugs increase upper gut motility and induce MMC's, but exert a differential response. Tegaserod produces a more sustained prokinetic effect in the duodenum/jejunum, whereas erythromycin predominantly increases antral motor activity.
authors: Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors: Issam
authors: I
authors: Nasr
authors: Satish S C
authors: SS
authors: Rao
authors: Ashok
authors: A
authors: Attaluri
authors: Syed M A
authors: SM
authors: Hashmi
authors: Robert
authors: R
authors: Summers
mesh_terms: D000328:Adult; D004917:Erythromycin / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005765:Gastrointestinal Agents / Q000494:pharmacology* / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000503:physiopathology; D041981:Gastrointestinal Tract / Q000187:drug effects*; D006801:Humans; D007211:Indoles / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D007211:Indoles; C105050:tegaserod; D004917:Erythromycin