Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study.
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Date
2009-07
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Abstract
Objectives Tegaserod may enhance upper gut transit, but, its prokinetic effects on antral/small bowel motility and how this
compares with erythromycin is unknown. We prospectively
assessed and compared the effects of tegaserod and erythromycin
on upper gut motility.
Methods In an open label, non-crossover study, 22 patients
(M/F=4/18; mean age=37 years) with symptoms of upper
gut dysmotility underwent 24-hour ambulatory antroduodenojejunal
manometry with a six-sensor solid state probe.
The effects of 12 mg oral tegaserod were compared with 125
mg intravenous erythromycin by quantifying pressure wave
activity and assessing motor patterns.
Results Motor activity increased (p<0.05) in antrum, duodenum
and jejunum with both drugs when compared to
baseline period. The motor response with tegaserod was
higher (p<0.05) in jejunum and occurred during the second
or third hours, whereas with erythromycin, it was higher
(p<0.05) in antrum and occurred within 30 minutes. After
tegaserod, a ‘fed-response’ like pattern was seen whereas after
erythromycin, large amplitude (>100 mmHg) antral contractions
at 3 cycles per minute were seen. Following tegaserod
and erythromycin, phase III MMCs occurred in 12 (55%)
and 8 (36%) patients respectively (p>0.05).
Conclusions Both drugs increase upper gut motility and
induce MMC’s, but exert a differential response. Tegaserod
produces a more sustained prokinetic effect in the duodenum/ jejunum, whereas erythromycin predominantly increases antral motor activity.
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Keywords
Dysmotility, erythromycin, small bowel manometry, tegaserod
Citation
Nasr Issam, Rao Satish S C, Attaluri Ashok, Hashmi Syed M A, Summers Robert. Effects of tegaserod and erythromycin in upper gut dysmotility: a comparative study. Indian Journal of Gastroenterology. 2009 Jul-Aug; 28(4): 136-142.