Gastroparesis and Malabsorptive Disorders Flashcards
What is the leading cause of gastroparesis?
longstanding diabetes
What are lifestyle modifications for gastroparesis?
- dietary fiber
- smaller meal volume, more frequent meals
- small particle diet (no peels or seeds)
How is gastroparesis prevented?
Keeping glucose < 200
What medications impair motility and exacerbate gastroparesis?
- anticholinergics (scopolamine, oxybutynin)
- GLP-1 agonists
- opioids
What is the MOA of Metoclopramide?
D2 receptor antagonist and 5HT4 receptor agonist
How long can Metoclopramide be used for gastroparesis?
12 weeks
What BBW does Metoclopramide have?
Increased risk of tardive dyskinesia with age, diabetes, and psychotic disorders
What can dystonias related to Metoclopramide be treated with?
antihistamines
benzos
anticholinergics
What are other SEs with Metoclopramide?
sedation
restlessness
QTc prolongation
What is the MOA of Erythromycin?
agonist to the motilin receptor; same MOA of traveler’s diarrhea
What are SEs with Erythromycin?
QTc prolongation
GI discomfort
Decreased efficacy over time
What CYP enzyme does Erythromycin inhibit?
CYP3A4
Since Domperidone is not FDA approved, what needs to happen to use it for gastroparesis?
Investigational New Drug form
What is the MOA of Domperidone?
D2 receptor antagonist
Why does Domperidone have a decreased risk of EPS?
does not cross BBB
