Esophageal release

Cisapride (27) is effective in the treatment of re/Iux esophagitis and constipation, with a novel mechanism thought to involve acetylchohne release in the gut. It IS devoid of CNS and cardiac side effects [23]... 

Metoclopramide increases lower esophageal sphincter tone, aids gastric emptying, and accelerates transit through the small bowel, possibly through the release of acetylcholine. 

The Hi Receptor and its Ligands. The H receptor mediates effects, through an increase in cyclic adenosine monophosphate (cAMP). such as gastric acid secretion relaxation of airway smooth muscle and of pulmonary vessels increased lower airway mucus secretion esophageal contraclion inhibition of basophil, but not mas cell histamine release inhibition of neutrophil activation and induction or suppressor T cells. There is no evidence that the H- receptor causes significant modulation of lung function in the healthy human subject or in the asthmatic. 

Cisapride is structurally similar to metoclopramide, but has no dopamine receptor antagonist activity and hence no central antiemetic effect. However, because it stimulates the release of acetylcholine in the gastrointestinal tract it is effective in conditions such as reflux esophagitis and gastroparesis. During clinical trials, the most frequent unwanted effects were diarrhea (5-11%) and abdominal pain (16% with 20 mg bd). 

Potassium, given separately or in combination with a diuretic, introduces the risk of esophageal injury attempts to provide potassium in modified-release formulations have simply transposed the site of injury from the esophagus to the small bowel (SEDA-10,187). 

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