Prokinetics: a list of new generation drugs

Currently, the frequent reason for contacting doctors is a problem in the work of the digestive tract. Practically for each of them the motor function is disturbed. However, they can manifest as symptoms of a disease that is not associated with the digestive system. In any case, you can not do without the drugs prokinetics group. The list of drugs in this group does not have a restrictive framework. Therefore, each doctor selects their drug depending on the course of the disease. Further we will consider in more detail, what is prokinetics, the list of preparations of new generation, Most commonly used for treatment.

Prokinetics: General Characteristics

Drugs that alter the motor activity of the intestinal tract, speed up the process of food transit and emptying, just belong to this group.

As mentioned above, there is no single list of these drugs in the gastroenterological literature. Each doctor includes his own list of medicines. They include medicines from other groups, such as: antiemetic, antidiarrheal, as well as some antibiotics of the macrolide group, hormonal peptides. First, we will find out what the pharmacological action of this group of drugs is.

Action of prokinetics

First of all, they activate the motility of the digestive tract, and also have an antiemetic effect. Such drugs accelerate the devastation of the stomach and intestines, improve the muscle tone of the gastrointestinal tract, inhibit pyloric and esophageal reflux. Prokinetics is prescribed as a monotherapy or in combination with other medications. They can be divided into several types according to the principle of action.

Types of prokinetics

The principle of action on different parts of the gastrointestinal tract is different in such drugs as prokinetics. The list of drugs should be divided into these types:

1. Dopamine receptor blockers:

• Selective 1st and 2nd generation.
• Non-selective.

2. Antagonists of 5-HT3 receptors.

3. 5-HT3 receptor agonists.

And now more in detail about these groups.

Dopamine receptor blockers

Preparations of this group are divided into selective and nonselective. Their action is that they stimulate the motor function of the stomach and have antiemetic properties. What are prokinetics? The list of medicines is as follows:

• "Metoclopramide."
• Bromopride.
• Domperidon.
• "Dimetpramid."

The main active ingredient is metoclopramide, it has been used for a long time. The action is as follows:

• Increased activity of the lower esophageal sphincter.
• Acceleration of the devastation of the stomach.
• Increase in the rate of food advancement through the thin and large intestine.

However, non-selective drugs can initiate serious side effects.

There are widely known first-generation prokinetics. List of drugs:

• "Cryukal".

• "Raglan".
• Perinorm.
• "Cerulean".

One of the disadvantages is the ability to cause signs and symptoms of Parkinsonism in adults and the dyskinetic syndrome in children, menstrual cycle disorders in women.

To selective preparations of the second generation are medicines with active active substance domperidone. These drugs do not cause strong adverse reactions, but others may appear:

• Drowsiness.
• Weakness.
• Anxiety.
• Headache.

It is for this reason that drugs with active substance domperidone - the best prokinetics. List of drugs:

1. "Motilium."
2. "Domidon".
3. "Motinorm".
4. "Motors".
5. "Gastropom."

Prokinetics of the new generation

Selective prokinetics of the second generation include preparations with the active substance of tautoprid hydrochloride. Such remedies have gained recognition due to their excellent healing effect and the absence of side effects even with prolonged use. Most often doctors appoint:

• "Itomed".
• "Ganatom".
• Itopride.

This can be explained by the positive properties of teopride hydrochloride:

1. Improvement of motor and evacuation functions of the stomach.
2. Increased activity of the gallbladder.
3. Increase the dynamism and tone of the muscles of the thick and small intestine.
4. Promoting the elimination of duodenogastric reflux.

Intestinal prokinetics

Prokinetics, agonists of 5-HT3 receptors, can be classified here. The active substance is tegaserod. It positively affects the motor and evacuation function of the thick and small intestine. Promotes normalization of the stool, reduces the symptoms of irritated bowel.

Does not cause an increase in blood pressure, does not affect the cardiovascular system. However, there are a sufficient number of side effects. The risk of stroke, angina pectoris, development of an anginal attack increases several times. Currently, preparations with this active substance have been discontinued in our country and in a number of other countries for further research. This includes the following prokinetics (list of drugs):

• "Tegaserod".
• Zelmak.
• Fractal.

5-HT3 receptor antagonists

The prokinetics of this group are suitable for the treatment and prevention of nausea and vomiting. When they are taken, the time of food stay in the stomach decreases, the speed of food transit through the intestine increases, and the tone of the large intestine normalizes.

The release of acetylcholine is observed, and the motor function of the gastrointestinal tract is improved. At present, prokinetics are in great demand among patients and physicians. List of new generation drugs:

• Tropisetron.
• "Osetron".
• Ondasetron.
• Silansetron.

It should be noted that antagonists of 5-HTZ receptors do not have a therapeutic effect if vomiting is caused by apomorphine.

These drugs are well tolerated, although they have side effects:

• Headache.
• Constipation.
• Tides of blood.
• Sensations of heat.

Another plus of these drugs - they do not have a sedative effect, do not interact with other drugs, do not cause endocrine changes, do not interfere with motor activity.

At what diseases are prescribed

As mentioned above, prokinetics is used in monotherapy or in combination with antibiotics. Doctors know that there are such diseases in which the appointment of prokinetics several times increases the effectiveness of treatment. This group includes:

1. Diseases of the digestive system with impaired motor activity.
2. Gastroesophageal reflux disease.
3. Peptic ulcer of the stomach (duodenum).
4. Idiopathic gastroparesis.
5. Vomiting.
6. Constipation.
7. Irritable bowel syndrome.
8. Diabetic gastroparesis.
9. Flatulence.
10. Nausea caused by drug and radiotherapy, infection, functional disorders, malnutrition.
11. Dyspepsia.
12. Dyskinesia of bile ducts.

Who should not take

For preparations of the prokinetic group, there are contraindications:

• Hypersensitivity to the active substance.
• Gastric or intestinal bleeding.
• Perforation of the stomach or intestines.
• Intestinal obstruction.
• Acute liver failure, impaired renal function.

Not recommended reception, if the work requires increased attention and concentration, as well as those who drive the car. With care appoint prokinetics to the elderly.

Pregnant and nursing mothers

I want to say a few words about taking medications during pregnancy. Studies have shown that prokinetics have the property of penetrating into breast milk, so for the period of treatment with such medications, breastfeeding should not be continued.

In the first trimester of pregnancy, women often have vomiting and nausea. In this case, the prescription of such drugs as prokinetics is possible. List of preparations for pregnant women Will include only those that do not pose a threat to the life of the pregnant woman and the fetus.

The benefit from it should exceed all possible risks. Prokinetics with the active substance metoclopromide can be used from this group only according to the doctor's prescription. Prokinetics are not prescribed in the subsequent trimesters of pregnancy.

Currently, the drugs of this group in pregnancy are not prescribed because of the large number of side effects.

Prokinetics for children

Prokinetics with active substance metoclopramide in children should be carefully cautious, since there is a risk of dyskinetic syndrome. It is prescribed depending on the weight of the child.

If the pediatrician appoints prokinetics, "Motilium" is most often included in this list. It has good tolerability and has many positive reviews. But other prokinetics may be prescribed. The list of preparations for children may contain the following names:

• Domperidon.
• "Metoclopromide."

It should be noted that for children under 5 years of age, the drug "Motilium" is recommended to be used as a suspension. The medication is prescribed depending on the weight of the child, at a rate of 2.5 ml for every 10 kg of weight. If necessary, the dose can be increased, but only for toddlers over the year. Also, the preparation is available in the form of tablets for resorption.

Prokinetics are prescribed for children if the child has:

• Vomiting.
• Nausea.
• Esophagitis.
• Delayed digestion of food.
• Dyspeptic symptoms.
• Frequent regurgitation.
• Gastroesophageal Reflux.
• Disturbance of motility of the gastrointestinal tract.

It should be noted that in the very first months of life the body of the child and all its functions are not very developed, therefore all drugs should be taken under strict observation and control of the doctor. In case of an overdose prokinetics can cause neurologic side effects in infants and young children.

Great popularity among parents of infants enjoys a herbal preparation that improves digestion and reduces gassing in the intestine. This concentrate is based on the fruits of fennel Plantex.

It is worth saying a few words about plant prokinetics.

Natural assistants

So the world is arranged, that the medicine for any illness can be found in any plant, it is necessary to know only - in what. So, vegetable prokinetics are known, which stimulate the motor function of the digestive tract. Here are some of them:

• Common fennel.
• Pharmaceutical camomile.
• The elderberry is black.
• Dill.
• Oregano.
• Motherwort.
• Dandelion.
• Melissa.
• Swine swine.
• Plantain large.
• The buckthorn is alder.

The list of plants that help improve the motility of the gastrointestinal tract, includes a large number of other representatives of the flora. It should also be noted that some vegetables and fruits have a similar effect:

• Swede.
• Melon.
• Cabbage.
• Carrot.
• Beet.
• Pumpkin.
• Cowberry.
• Grapes.

Prokinetics properties of these vegetables are very good, if fresh juices are prepared from them.

It should be noted that it is not necessary to replace medicinal preparations with herbs during periods of exacerbation of diseases and without consulting a doctor.

Side effects

It is very important that prokinetics of the new generation have much fewer side effects than first-generation drugs with the active substance of metoclopramide. However, even the newest drugs have side effects:

• Headache.
• Increased excitability.
• Dry mouth, thirst.
• Spasm of smooth musculature of the organs of the gastrointestinal tract.
• Hives, rash, itching.
• Hyperprolactinemia.
• In children, extrapyramidal symptoms may appear.

After drug cancellation, side effects completely pass.

If the doctor prescribes prokinetics, the list of drugs may include several drugs with different names, but with one active ingredient. However, the side effects will be the same.

Peculiarities of prokinetic use

It is very cautious to prescribe prokinetics to people with hepatic insufficiency and with poor kidney function. Such patients should be under the strict supervision of a doctor.

With prolonged use of prokinetics, patients should also visit their doctor more often. Be wary of prokinetics in young children, especially up to one year.

Caution is necessary to prescribe drugs from this group to elderly patients.

When treating prokinetics, do not engage in work that requires increased attention and quick response.

Before taking it, you should always consult a doctor. Your health depends on it. Do not replace the medical product with its vegetable analog without first consulting a doctor.