peristaltic motor activity of the gut is an essential ... · cyra ls tablet 10x10 systopic 9.90/tab...
TRANSCRIPT
Peristaltic motor activity of the gut is an essential activity for digestion and absorption and absorption of nutrients to sustained life
• Gut is made up of smooth muscles and smooth muscle contraction depends upon acetylcholine.
• Dopamine decreases the acetylcholine level while
• serotonin increases acetylcholinelevel,
• therefore dopaminergic and serotonergic activity balances the gut motility.
Receptors of GI Tract
SN Name of receptor Funtions
1 5 HT4 Receptors (seratonin) Lower Esophageal sphincter contraction, Ach Release, Peristalsis , Intestinal Mucosa secretion
2 D2 Receptors (dopamine)
Inhibition (delay gastric emptying time) LES relexation
5 HT receptors are found in cholinergic neuron in enteric nervous system where they induce release of acetyl choline which stimulate gastric emptying time motility.
Other factor affecting GI motility
Factors Affect On GI Motility
Food Intake
Clear fluid empty rapidly (+-30 min, Solid 1-2 hrs. Protein empties fast , followed by carbohydrate. Fat take long time.
PH of Stomach
Hyperacidity slows down GI Motility
Patient Factor
Pregnancy, Anxiety, Pain
Disease state diabetes mellitus
Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Normally, the muscles of the stomach, which are controlled by the vagus nerve, contract to break up food and move it through the gastrointestinal (GI) tract.
Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve.
46.5% of patients with IBS Also have GERD.
Requirement of compressive as well fast treatment for rapid relief
Introducing
Levosulpiride acts as a moderate agonist at the 5-HT4 receptor. This property, together with antagonism at D1 & D2 receptors, contribute to its gastrointestinal prokinetic effect.
Mode of Action
Rabeprazole belongs to a class of antisecretory compounds substituted benzimidazole. Rabeprazole suppress gastric acid secretion by inhibiting the gastric H+, K+ ATPase at the secretory surface of the gastric parietal cell. Rabeprazole blocks the final step of gastric acid secretion.
In gastric parietal cells.
Pharmacokinetic data of Rabeprazole
Parameters Rabeprazole Levosulpiride
Bioavailability 52% 30%
Metabolism Mostly non-
enzymatic partly
hepatic (CYP2C19
& CYP3A4)
Mostly by Hepatic
enzymatic reactions
Biological
Half-Life
1 – 1.5 hrs 9.7 hrs
Excretion 90%, Renal Renal
Parameters Levosulpiride
Domperidone Metoclopramide
Anti-emetic &
Prokinetic
Activity
More
Less
Less
Site of
prokinetic
action
Entire Gut Upper gut Upper Gut
Role in IBS-
Constipation Yes No No
Superior to Domperidone and Metoclopramide
Dosage :- As directed by Physician
Therapeutic Indications
•Functional Dyspepsia •Diabetic Gastroparesis •IBS with Constipation •GERD
Contraindications:-Epilepsy, Hyperprolactinaemia, GI Bleeding
Presentation:- 10X10 capsules MRP 82.00/10 Caps
Competitors for Rabopep L Capsules
Brand Name Packing Company MRP
Cyra LS Tablet 10x10 Systopic
9.90/Tab
Rabekind LS Cap 10x10 Mankind 8.80/Cap
Happi-L Cap 10x10 Zydus 13.00/Cap
Rekool -L Tab 10x10 Alembic 15.00/TAb
Rabifast-XL Cap 10x10 Zuventus 13.00/Cap
Rabicip-L Cap 10x10 Cipla 15.00/Cap