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Gastrointestinal Motility Modulation: Pharmacological Agents and Mechanisms

Explore the impact of various drugs on GI motility and secretion, including opioid receptor antagonists and 5-HT modulators. Understand the complex interplay of neurotransmitters involved in peristaltic reflexes.

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Gastrointestinal Motility Modulation: Pharmacological Agents and Mechanisms

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  1. NA or other + 5-HT Enk + + + NANC 5HT3 5HT4 - + ACh DA - D2 Enk + - WATEREXCRETION 5HT1or2  ProximalContraction DistalRelaxation ACh - , - PERISTALTIC REFLEX

  2. Water Excretion NA orother ACh ACh + + X - Motility

  3. Don’t forget hormone actions esp. motilin, somatostatin ACh + Motility

  4. ACh DA - D2 +

  5. X ACh METOCLOPRAMIDE DA - D2 +

  6. NANC 5HT3 ACh 5HT4 - + ACh + 5-HT ProximalContraction DistalRelaxation + + PERISTALTIC REFLEX

  7. ACh 5HT4 + ACh + CISAPRIDE TEGASEROD(5HT4 agonists)

  8. ONDANSETRONALOSETRON(5HT3 antagonists) X NANC 5HT3 - ACh + 5-HT + INCREASED CONTRACTION BUT DECREASED MOTILITY!

  9. ACh Enk + - , -

  10. - NA or other 5HT1or2 + Enk  5-HT + ACh Enk + + inhibition of 5-HT mediating segmentation (not shown) - , -

  11. NA or other ACh + - 5HT1or2 +  5-HT DIPHENOXYLATE LOPERAMIDE ,

  12. - NA or other + 5HT1or2 5-HT Enk  + + + NANC 5HT3 ACh 5HT4 - + ACh - , - DA - D2 Enk + ALVIMOPAN and METHYLNALTREXONEare opioid receptor antagonists that increase motility and increase secretion The “SETRONS”are 5Ht3antagonist s that inhibit peristalsis CISAPRIDE and TEGASEROD are5Ht4 agonist s that increase motility METOCLOPRAMIDE is a DA antagonis thatacts as cholinomimeticsto increase motility DIPHENOXYLATE & LOPERAMIDE areopioids that decrease motilityand reduce secretion

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