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| Gastric Motility Disorder Drug |
Gastric
motility refers to the coordinated contractions of the stomach muscles that
help mix and propel food through the digestive tract. Disorders involving
impaired or abnormal gastric motility can negatively impact digestion.
What are GMD?
GMD involve conditions where the normal propulsion and emptying of food from
the stomach is compromised or disrupted. Some common types include:
Gastric
Motility Disorder Drug or Delayed Gastric Emptying: Food stays in the
stomach for an abnormally long time rather than emptying into the small
intestine at a normal rate. This can cause symptoms like postprandial fullness,
nausea, bloating, and vomiting.
Gastroparesis: A condition where the stomach takes too long to empty its
contents due to a malfunction of the vagus nerve or damage to gastric motor
neurons. This delays the time it takes for food to transition from the stomach
to the small intestine.
Gastroesophageal Reflux Disease (GERD): A digestive disorder where stomach
contents and acid flow back up into the esophagus. Poor stomach emptying may
contribute to GERD in some cases.
Drug Therapies for GMD
When lifestyle modifications and dietary changes are insufficient to control
symptoms, prescription medications may provide relief for patients with gastric
motility disorder drug. Here are some of the drugs commonly prescribed:
Prokinetics: As the name suggests, these drugs work to stimulate gastric emptying
and promote motility. Common prokinetics prescribed include metoclopramide
(Reglan), domperidone, and erythromycin. However, some carry risks like
extrapyramidal side effects.
Acetylcholinesterase Inhibitors: By blocking the breakdown of acetylcholine
(which can help stimulate contractions), drugs like pyridostigmine (Mestinon)
help promote gastric emptying. Mestinon is commonly used off-label for
gastroparesis.
Betahistine (Serc): A partial histamine agonist that increases gastric
motility. Available internationally but not FDA-approved in the US. However, it
is sometimes obtained via international pharmacies.
Botox Injections: May provide relief of gastric stasis symptoms by relaxing the
pyloric muscle of the stomach outlet and allowing contents to drain more easily
into the duodenum. Botox injections require endoscopy.
H2 Blockers & Proton Pump Inhibitors: Drugs like ranitidine (Zantac) and
omeprazole (Prilosec) help reduce stomach acid levels, providing symptom relief
for conditions involving excessive reflux like GERD. However, they do not
directly impact gastric emptying.
Latest Options: Ghrelin Agonists, Motilin Agonists & 5-HT4 Agonists
More recently approved medications target specific pathways to stimulate
gastric motility. For example:
- Ghrelin is a hormone that increases hunger and gastric emptying. A ghrelin
receptor agonist called relamorelin (RC-1291) showed promise for gastroparesis
in phase III trials.
- Motilin plays a key role in gastric emptying. Motilin receptor agonists like
mitemcinal (LINZO-1) are in development.
- 5-HT4 serotonin receptors partially mediate prokinetic pathways. Prucalopride
(Motegrity) provides relief for GERD and idiopathic constipation due to its
5-HT4 properties.
- Several Phase III trials are ongoing to evaluate these newer agent's
long-term safety and efficacy for gastroparesis and gastric motility disorder
drug. They represent promising targeted options beyond non-specific prokinetics
if approved.
Considerations in Gastric Motility Drug Treatment
Choosing appropriate gastric motility medications requires weighing different
factors:
- Identifying the specific disorder (e.g. gastroparesis vs gastric stasis) to
target symptoms appropriately.
- Considering any contraindications or risks like extrapyramidal effects for
some prokinetics.
- Patient preferences regarding dosing schedule, side effects, or goal to
alleviate specific symptoms.
- Potential drug interactions with other gastrointestinal or chronic
medications.
- Monitoring treatment response and adjusting therapy if symptoms are not
adequately controlled over time.