Propulsive motility

Diphenoxylate Hydrochloride. l-(3-Cyano-3,3-diphenylpropyl)-4-phenyl-4-piperidinecarboxyhc acidmonohydrochlorhydrate [3810-80-8] (Lomotil) (13) is a white, odorless, crystalline powder that melts at 220—226°C. It is soluble ia methanol, spariagly soluble ia ethanol and acetone, slightly soluble ia water and isopropyl alcohol, freely soluble ia chloroform, and practically iasoluble ia ether and hexane. The method of preparation for diphenoxylate hydrochloride is available (11). Diphenoxylate hydrochloride [3810-80-8] (13) is an antidiarrheal that acts through an opiate receptor. It has effects both on propulsive motility and intestinal secretion. Commercial forms are mixed with atropiae to discourage abuse. 

In neonatal foals, enteritis is associated with the accumulation of fluid in the bowel lumen and either poor propulsive motility or excessive contractions of the bowel. Also, neonatal foals with septicemia often have poor intestinal motility. In these cases, neither enteral feeding nor pharmacological stimulation of intestinal motility is indicated. In older foals, duodenitis is associated with... 

Ogata N, Ataka K, Morino H, et al. 1999. Effect of wood creosote and loperamide on propulsive motility of mouse colon and small intestine. Pharmacology 59 212-220. 

This and other nonabsorbable sugars such as sorbitol and mannitol are hydrolyzed in the colon to short-chain fatty acids, which stimulate colonic propulsive motility by osmotically drawing water into the lumen. Sorbitol and lactulose are equally efficacious in the treatment of constipation caused by opioids and vincristine, of constipation in the elderly, and of idiopathic chronic constipation. They are available as 70% solutions, which are given in doses of 15 to 30 mL at night, with increases as needed up to 60 mL per day in divided doses. Effects may not be seen for 24 to 48 hours rafter dosing is begun. Abdominal discomfort or distention and flatulence are relatively common in the first few days of treatment but usually subside with continued administration. A few patients dislike the sweet taste of the preparations dilution with water or administering the preparation with fruit juice can mask the taste. 

Of the drugs listed, only metoclopramide is considered a prokinetic agent, ie, one that increases propulsive motility in the gut. The answer is (D). 

The discussed cannabinoid-induced effects on intestinal peristalsis are reportedly completely countered by SR141716A, suggesting they are CBi receptor mediated (41,43,44). However, the inhibitory action of melhanandantide on distension-induced propulsive motility is also sensitive to the presence of l-NAME (a nitric oxide synthase inhibitor) and apantine (an inhibitor of Ca2+-dependent potassinm channels) (44). 

Cholinergic agents (e.g., carbamylcholine, which mimics the action of ACh) stimulate propulsive motility. 

Cholinesterase inhibitors allow the accumulation of natural ACh, thus stimulating propulsive motility. 

Direct irritants (e.g., castor oil, aloe, cascara sagrada, histamine, and cardiac or saponin glycosides) stimulate smooth muscle In the intestinal wall and increase propulsive motility in an attempt to move irritants more quickly through the intestinal tract. 

Osmotic cathartics increase fluid accumulation, stretching the intestinal wall and Initiating reflex propulsive motility. 

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