Prokinetics

• Prokinetic overview


  GI stimulants that stimulate motility without stimulating secretions

  used for gastroparesis, GERD, emesis
• Prokinetic examples


  Metoclopramide

  no others are used
• Prokinetic pharmacodynamic


  stimulates motility in upper GI tract by sensitizing tissues to acetylcholine

  results in increased tone of gastric contractions, relaxation of pyloric sphincter, increased peristalsis in the small intestine

  also works as a dopamine receptor antagonist in the CNS and can produce sedation and extrapyramidal symptoms
• Prokinetics precaution and contraindication

  Metoclopramide carries the risk of tardive dyskinesia and other extrapyramidal symptoms

  contraindicated in presence of diseases or drugs that stimulate GI motility

  cautious with depression due to sedating effects

  contraindicated in hypersensitivity and pheochromocytoma

  cautious in children
• Prokinetics adverse reactions


  EPS

  depression, dizziness, diarrhea, hypoglycemia