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NA or other. +. 5-HT. Enk. +. +. +. NANC. 5HT 3. 5HT 4. -. +. ACh. DA. -. D2. Enk. +. -. WATER EXCRETION. 5HT 1or2. . Proximal Contraction. Distal Relaxation. ACh. -. ,. -. PERISTALTIC REFLEX. Water Excretion. NA or other. ACh. ACh. +. +. X. -. Motility.
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NA or other + 5-HT Enk + + + NANC 5HT3 5HT4 - + ACh DA - D2 Enk + - WATEREXCRETION 5HT1or2 ProximalContraction DistalRelaxation ACh - , - PERISTALTIC REFLEX
Water Excretion NA orother ACh ACh + + X - Motility
Don’t forget hormone actions esp. motilin, somatostatin ACh + Motility
ACh DA - D2 +
X ACh METOCLOPRAMIDE DA - D2 +
NANC 5HT3 ACh 5HT4 - + ACh + 5-HT ProximalContraction DistalRelaxation + + PERISTALTIC REFLEX
ACh 5HT4 + ACh + CISAPRIDE TEGASEROD(5HT4 agonists)
ONDANSETRONALOSETRON(5HT3 antagonists) X NANC 5HT3 - ACh + 5-HT + INCREASED CONTRACTION BUT DECREASED MOTILITY!
ACh Enk + - , -
- NA or other 5HT1or2 + Enk 5-HT + ACh Enk + + inhibition of 5-HT mediating segmentation (not shown) - , -
NA or other ACh + - 5HT1or2 + 5-HT DIPHENOXYLATE LOPERAMIDE ,
- 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