PROKINETICOS EN

GERD


DENISSE TAFUR CHANG

 METOCLOPRAMIDE

 ANTAGONISTA DEL RECEPTOR DE DOPAMINA
 MECANISMO DE ACCION
 USO
 EFECTOS ADVERSOS

Lüllmann, Color Atlas of Pharmacology © 2000 Thieme

 Metoclopramide, thickened feedings, and positioning for gastro-
oesophageal reflux in children under two years


 Thickened feeds are helpful in reducing the symptoms of
GER. Elevating the head of the crib in the supine position
does not have any effect. Metoclopramide may have
some benefit in comparison to placebo in the
symptomatic treatment for GER, but that must be
weighed against possible side effects

Cochrane Database Syst Rev. 2010;(5):CD003502.

 IN GERD

 Promotility agents are hampered by side effects that
limit their use, leading the United States Food and
Drug Administration (FDA) to impose a black box
warning on metoclopramide because of the risk of
tardive dyskinesia

American Gastroenterological Association Institute technical review on the

management of gastroesophageal reflux disease. Gastroenterology. 2008;135(4):1392.
 

American Gastroenterological Association Medical Position Statement on the

Management of Gastroesophageal Reflux Disease. SEPT, 2008
 ERITROMICINA

 AGONISTA DE LA MOTINA
 SE HA ESTUDIADO SU EFECTO PROKINETICO
EN:
 GASTROPARESIS DIABETICA
 GASTROPARESIS POST VAGOTOMIA
 GASTROPARESIS EN ESTADO CRITICO CON
VENTILACION MECANICA
 DISMOTILIDAD INTESTINAL EN INFANTES
 
Erythromycin as a prokinetic: Is the
overall benefit corroborated?

Singh NK - Crit Care Med - 01-MAY-2007; 35(5): 1446

 
 A meta-analysis reported that erythromycin was most
potent at stimulating gastric emptying, whereas
erythromycin and domperidone both were superior to
metoclopramide in control of symptoms.

 At least three controlled trials and six open labeled

trials have been published on use of erythromycin in
gastroparesis; other studies have examined the benefits
of the drug in functional dyspepsia with delayed
gastric emptying.Symptom benefits were observed in
six of nine gastroparesis studies
Gastroenterol Clin N Am 36 (2007) 619–647
 AZITROMICINA


J Neurogastroenterol Motil. 2010 October; 16(4): 407–413.