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Cisapride works on the
acetylcholine release and blocks the dopamine receptors, but to a lesser
effect than metoclopramide
HCl. This will affect mainly the motility of the GI tract. It acts mainly
on the lower esophageal sphincter, increases the pressure in the lower part
of the esophagus. It has thus an activating effect on the lower esophageal
peristasis and accelerates the emptying of the stomach content into the
intestine, but does not affect gastric secretion, and enhances peristalsis of
the small intestine and colon. Cisapride is used mainly in the treatment of
gastric disorders and megacolon. Since the body adapts to the
presence of a gut motility drug, and stops producing its own molecules that
normally stimulate the GI tract, it is advisable not to stop the
administration of gut motility drugs abruptly. If so, the onset of stasis is
often observed. Their dose should be decreased daily over a period of a week
or more, so that the body can start the production of its own
molecules/hormones gradually again. Adverse effects: cisapride
should not be used in case of gastro-intestinal bleeding, total blockage or
with a perforated intestine. Other effects are toxicosis with diarrhea,
tremors, convulsions, etc. In case of renal failure, history of epilepsy (rare
in rabbits), or gastric obstruction, the drug should not be used. This drug should to be given
15 to 30 min before a meal. When it is given together with other drugs that
are absorbed in the stomach, one should keep in mind that its absorption will
be decreased; the contrary for drugs to be absorbed in the intestine.
Cisapride increases the effect of cimetidine, anticoagulants or
benzodiazepine. Concurrent use of cisapride with ketoconazole, itraconazole
or miconazole may result in the appearance of ventricular arrythmias. The use of anticholinergic
agents will negate the effect of beneficial effects of cisapride. Though little scientific
evidence is available, cisapride seems to stimulate the voiding of the
bladder, but only if there is no nerve damage. Dosage safe for
use in rabbits: 0.5
mg/kg once daily to tid - qid,
PO, SC. |
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