Role and safety of prokinetic drugs in the treatment of upper gastrointestinal motility disorders: an Indian perspective

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dc.contributor.authorChaudhuri, S.en_US
dc.date.accessioned2024-09-24T09:18:18Z
dc.date.available2024-09-24T09:18:18Z
dc.date.issued2023-10
dc.description.abstractUpper gastrointestinal (GI) motility disorders such as functional dyspepsia (FD), gastroesophageal reflux disease, and gastroparesis are associated with symptoms such as acid reflux, regurgitation, bloating, and heartburn. This review summarizes the prevalence, diagnosis and management of upper GI motility disorders in clinical practice in India, with focus on the use of prokinetics. Lifestyle and dietary modifications, psychotherapy, and pharmacotherapy form the armamentarium for management of motility disorders. Among pharmacotherapies, prokinetics increase gastric emptying and provide symptomatic relief. However, neurological and cardiovascular safety issues are associated with commonly prescribed prokinetics making it important to judiciously select an appropriate drug after weighing out its risk-benefit profile. While metoclopramide, domperidone, and levosulpiride are widely prescribed prokinetics in Indian clinical practice, they are associated with adverse effects such as extrapyramidal symptoms (EPS) and cardiovascular side effects. Itopride, which is a prokinetic with dual mechanism of action, has been found to have equivalent efficacy to other prokinetics and has shown significant improvement in quality of life and symptoms in randomized controlled trials in patients with FD. It acts as a D2 receptor antagonist and acetylcholinesterase inhibitor. Both these actions cause increase in acetylcholine levels, which increases gastric motility. Itopride also has negligible cardiac and neurological safety concerns. Thus, it is a relatively safer molecule compared with other prokinetics, with no EPS or cardiotoxicity concerns and can be used for the long-term management of upper GI motility disorders in a wide pool of patient groups either alone or in combination with other drug classes.en_US
dc.identifier.affiliationsDepartment of Gastroenterology, AMRI Hospitals, Kolkata, West Bengal, Indiaen_US
dc.identifier.citationChaudhuri S. . Role and safety of prokinetic drugs in the treatment of upper gastrointestinal motility disorders: an Indian perspective. International Journal of Research in Medical Sciences. 2023 Oct; 11(10): 3937-3944en_US
dc.identifier.issn2320-6071
dc.identifier.issn2320-6012
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/233524
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber10en_US
dc.relation.volume11en_US
dc.source.urihttps://doi.org/10.18203/2320-6012.ijrms20233067en_US
dc.subjectProkineticsen_US
dc.subjectFunctional GI disordersen_US
dc.subjectMotilityen_US
dc.subjectItoprideen_US
dc.titleRole and safety of prokinetic drugs in the treatment of upper gastrointestinal motility disorders: an Indian perspectiveen_US
dc.typeJournal Articleen_US
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