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Prokinetic drugs (motility stimulants)

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Metoclopramide and domperidone:

  • dopamine antagonists which stimulate gastric emptying and small intestinal transit
  • enhance oesophageal sphincter contraction in reflux
  • useful in non-ulcer dyspepsia and non-specific or cytotoxic-induced nausea and vomiting
  • metoclopramide and occasionally domperidone may induce an acute dystonic reaction, particularly in young women and children.

Cisapride:

  • motility stimulant releasing with no dopamine-antagonist properties acetylcholine in gut wall
  • useful in oesophageal reflux, gastric stasis and non-ulcer dyspepsia
  • drugs inhibiting cisapride metabolism can increase plasma concentration and cause disturbances of cardiac rhythm.

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