Gastroparesis treatment

Unlabeled Uses Systemic Treatment of acne vulgaris, chancroid, Campylobacter enteritis, gastroparesis, Lyme disease, diabetic gastroparesis Topical Treatment of minor bacterial skin infections... 

Unlabeled Uses Treatment of diabetic gastroparesis, sexual dysfunction associated with the use of selective serotonin reuptake inhibitors... 

While the 5-HT3 receptor is the most important in control of nausea and vomiting, others are also involved. 5-HT4 agonists have prokinetic properties in nauseated patients with gastroparesis and functional dyspepsia. The 5-HTlD-receptor agonists, such as sumatripan, are used in treatment of migraine and reduce emesis both in this condition and also in the cyclic vomiting syndrome, most likely via action on CNS sites. 

These agents are widely used in the treatment of patients with delayed gastric emptying due to postsurgical disorders (vagotomy, antrectomy) and diabetic gastroparesis. Metoclopramide is sometimes administered in hospitalized patients to promote advancement of nasoenteric feeding tubes from the stomach into the duodenum. 

Patterson D, Abell T, Rothstein R, Koch K, Barnett J. A double-bhnd multicenter comparison of domperidone and metoclopramide in the treatment of diabetic patients with symptoms of gastroparesis. Am J Gastroenterol 1999 94(5) 1230-4. 

Vandenplas Y, Hauser B, Salvatore S. Current pharmacological treatment of gastroparesis. Expert Opin Pharmacother 2004 5(11) 2251. ... 

Oral metoclopramide is indicated in the treatment of diabetic gastroparesis (10 mg 30 minutes before each meal and at bedtime for 2 to 8 weeks) and symptomatic gastroesophageal reflux (10 to 15 mg orally up to 4 times daily 30 minutes before each meal and at bedtime for 4 to 12 weeks). Furthermore, parenteral metoclopramide is indicated in prevention of nausea and vomiting associated with emetogenic cancer chemotherapy, for prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable, and as a single dose to facilitate small-bowel intubation when the tube does not pass the pylorus with conventional maneuvers. 

Sugumar A, Singh A, Pasricha PJ. A systematic review of the efficacy of domperi-done for the treatment of diabetic gastroparesis. Clin Gastroenterol Hepatol 2008 6 726-33. 

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