Currently, a common reason for going to doctors is problems in the digestive tract. Virtually each of them is characterized by impaired motor function. However, they can manifest themselves as symptoms of a disease that is not related to the digestive system. In any case, you can not do without the drugs of the 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. Next, we consider in more detail what prokinetics are, a list of new generation drugs, most commonly used for treatment.
Prokinetics: General Description
Medicines that change the motor activity of the intestinal tract, accelerate the process of food transit and emptying, just belong to this group.
As mentioned above, a single list of these drugs in the gastroenterological literature does not exist. Each doctor includes here his list of drugs. They include medicines of other groups, such as antiemetic, antidiarrheal, as well as some antibiotics of the macrolide group, hormonal peptides. First, find out what is the pharmacological effect of this group of drugs.
Prokinetics action
First of all, they activate the motility of the digestive tract, and also have an antiemetic effect. Such drugs accelerate the emptying of the stomach and intestines, improve the muscle tone of the gastrointestinal tract, and inhibit pyloric and esophageal reflux. Prokinetics are prescribed as monotherapy or in combination with other drugs. 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 for drugs such as prokinetics. The list of drugs should be divided into the following types:
1. Dopamine receptor blockers:
- Selective 1st and 2nd generation.
- Non-selective.
2. Antagonists of 5-HT3 receptors.
3. Agonists of 5-HT3 receptors.
And now more about these groups.
Dopamine receptor blockers
Preparations of this group are divided into selective and non-selective. Their action is that they stimulate the motor function of the stomach and have antiemetic properties. What are these prokinetics? The list of drugs is as follows:
- "Metoclopramide."
- "Bromoprid."
- Domperidone.
- "Dimetpramide."
The main active substance is metoclopramide, it has been used for a long time. The action is as follows:
- Increased activity of the lower esophageal sphincter.
- Acceleration of empty stomach.
- The increase in the rate of advancement of food through the small and large intestines.
However, non-selective drugs can trigger serious side effects.
There are widely known first generation prokinetics. List of drugs:
- "Raglan".
- Perinorm.
- "Tseruglan".
One of the disadvantages is the ability to cause signs and symptoms of parkinsonism in adults and dyskinetic syndrome in children, menstrual irregularities in women.
Second-generation selective drugs include drugs with the active ingredient domperidone. These medicines do not cause severe adverse reactions, but others may appear:
- Drowsiness.
- Weakness.
- Anxiety.
- Headache.
For this reason, drugs with the active substance domperidone are the best prokinetics. List of drugs:
- Motilium.
- Domidon.
- "Motinorm."
- "Motoriks".
- "Gastropom."
Prokinetics of the new generation
Selective prokinetics of the second generation include drugs with the active substance itopride hydrochloride. Such funds have won recognition due to the excellent therapeutic effect and the absence of side effects, even with prolonged use. Most often, doctors prescribe:
- Itomed.
- "Ganatom."
- Itoprid.
This can be explained by the positive properties of itopride hydrochloride:
- Improving the motor and evacuation function of the stomach.
- Increased gallbladder activity.
- Increased dynamism and muscle tone of the large and small intestines.
- Contributing to the elimination of duodenogastric reflux.
Intestinal Prokinetics
These include prokinetics — agonists of 5-HT3 receptors. The active substance is tegaserod. It positively affects the motor and evacuation function of the large and small intestines. Helps normalize stool, reduces the symptoms of irritable bowel.
It does not cause an increase in pressure, does not affect the cardiovascular system. However, there are a sufficient number of side effects. The risk of stroke, angina pectoris, and the development of an anginal attack is several times increased. Currently, preparations with this active substance are discontinued in our country and in a number of other countries for further research. These include the following prokinetics (list of drugs):
- "Tegaserod."
- Zelmak.
- Fractal.
5-HT3 receptor antagonists
Prokinetics of this group are suitable for the treatment and prevention of nausea and vomiting. When they are taken, the time the food stays in the stomach decreases, the speed of food transit through the intestine increases, and the tone of the large intestine normalizes.
Acetylcholine release is observed, and motor function of the gastrointestinal tract improves. Currently, modern prokinetics are in great demand among patients and doctors. The list of new generation drugs:
- Tropisetron.
- "Sturgeon".
- 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.
- Hot flashes.
- Feelings of heat.
Another plus of these drugs is that they do not have a sedative effect, do not interact with other drugs, do not cause endocrine changes, and do not violate motor activity.
What diseases are prescribed
As mentioned above, prokinetics are used in monotherapy or in conjunction with antibiotics. Doctors know that there are diseases in which the appointment of prokinetics several times increases the effectiveness of treatment. This group includes:
- Digestive system disorders with impaired motor activity.
- Gastroesophageal reflux disease.
- Peptic ulcer of the stomach (duodenum).
- Idiopathic gastroparesis.
- Vomiting
- Constipation
- Irritable bowel syndrome.
- Diabetic gastroparesis.
- Flatulence.
- Nausea caused by drug and radiotherapy, infection, functional impairment, malnutrition.
- Dyspepsia.
- Biliary dyskinesia.
Who should not be taken
For prokinetics group preparations, 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.
Reception is not recommended if the work requires increased attention and concentration, as well as those who drive a car. Prokinetics are prescribed with caution to the elderly.
Pregnant and lactating mothers
I want to say a few words about taking medications during pregnancy. Studies have shown that prokinetics tend to pass into breast milk, so breast-feeding should not be continued for the duration of treatment with such drugs.
In the first trimester of pregnancy, women often experience vomiting and nausea. In this case, it is possible to prescribe drugs such as prokinetics. List of drugs for pregnant women will include only those that do not pose a threat to the life of the pregnant woman and the fetus.
The benefits of it should exceed all possible risks. Prokinetics with the active substance metoclopromide can be used from this group only as directed by a doctor. In subsequent trimesters of pregnancy, prokinetics are not prescribed.
Currently, drugs of this group during pregnancy are not prescribed due to the large number of side effects.
Prokinetics for children
Apply prokinetics with the active substance metoclopramide in children should be especially careful, since there is a risk of dyskinetic syndrome. It is prescribed depending on the weight of the child.
If the pediatrician prescribes prokinetics, Motilium is most often on this list. It has good tolerance and has many positive reviews. But other prokinetics may be prescribed. The list of drugs for children may also contain the following names:
- Domperidone.
- "Metoclopromide."
It is worth noting that for children under 5 years of age, the drug Motilium is recommended to be used in the form of a suspension. The medicine is prescribed depending on the weight of the child, at the rate of 2.5 ml for every 10 kg of weight. If necessary, the dose can be increased, but only for babies older than a year. Also, the drug is available in the form of lozenges.
Prokinetics for children are prescribed if the child has:
- Vomiting
- Nausea.
- Esophagitis.
- Slow digestion of food.
- Dyspeptic symptoms.
- Frequent spitting up.
- Gastroesophageal reflux.
- Violation of motility of the gastrointestinal tract.
It should be noted that in the very first months of life, the child’s body and all its functions are not very developed, so all drugs should be taken under the strict supervision and supervision of a doctor. In case of an overdose, prokinetics can cause neurological side effects in infants and young children.
A herbal preparation that improves digestion and reduces gas formation in the intestine is very popular among parents of infants. This is a concentrate based on Plantex fennel fruits.
It is worth saying a few words about plant prokinetics.
Natural helpers
The world is so arranged that a cure for any ailment can be found in any plant, you only need to know in which one. So, plant prokinetics are known that stimulate the motor function of the gastrointestinal tract. Here is some of them:
- Ordinary fennel.
- Pharmaceutical camomile.
- Elderberry is black.
- Dill.
- Oregano.
- Motherwort.
- Dandelion.
- Melissa.
- Swamp marsh.
- Plantain is big.
- Buckthorn alder.
The list of plants that help improve gastrointestinal motility includes a large number of other representatives of the flora. It should also be borne in mind that some vegetables and fruits have a similar effect:
- Swede.
- Melon.
- Cabbage.
- Carrot.
- Beet.
- Pumpkin.
- Lingonberry.
- Grapes
The properties of prokinetics in these vegetables manifest themselves very well if fresh juices prepared from them are taken.
It should be noted that medicines should not be replaced with herbal remedies during periods of exacerbation of diseases and without consulting a doctor.
Side effects
It is very important that the new generation prokinetics have much fewer side effects than the first generation drugs with the active substance metoclopramide. However, the newest drugs have side effects:
- Headache.
- Hyperactivity.
- Dry mouth, thirst.
- Spasm of smooth muscles of the gastrointestinal tract.
- Urticaria, rash, itching.
- Hyperprolactinemia
- Extrapyramidal symptoms may appear in infants.
After discontinuation of the drug, side effects completely disappear.
If the doctor prescribes prokinetics, the list of drugs may include several drugs with different names, but with one active active substance. In this case, side effects will be the same.
Features of the use of prokinetics
Very carefully, prokinetics should be prescribed to people with liver failure and with poor kidney function. Such patients should be under the strict supervision of a physician.
With prolonged use of prokinetics, patients should also visit their doctor more often. Use with caution prokinetics in young children, especially up to one year.
Caution is necessary to prescribe drugs from this group to elderly patients.
In the treatment of prokinetics, you should not engage in work requiring increased attention and a quick reaction.
Before reception it is necessary to consult with the doctor. Your health depends on it. It is not necessary to replace a medicinal product with its herbal counterpart without prior consultation with a doctor.