Cisapride vs metoclopramide in dogs. Smooth muscle prokinetic (e.

Cisapride vs metoclopramide in dogs This abnormality has not Cisapride is a prokinetic agent which restores motility of the gastrointestinal tract in conditions of decreased bowel transit. Metoclopramide has gastrointestinal and central nervous system effects. The substituted benzamides, metoclopramide and cisapride, are mainly metabolized by the liver and may interact with other drugs. • Pre-anaesthetic metoclopramide and ranitidine did not reduce GOR. JoAnna Pendergrass, DVM, is a veterinarian and medical writer in Atlanta, Ga. Colonic distention can trigger the vomiting reflex in cats. Both will help reduce the nausea created by food pooling in the Results suggested that orally administered cisapride may be of benefit in canine patients for which an increase in LES pressure is desirable, whereas orally administered metoclopramide did not While both cisapride and metoclopramide normalized impaired solid emptying, cisapride at its highest dosage (10 mg) resulted in significantly faster gastric emptying (P = 0. They act restless or o Metoclopramide group – 1/30 dog. 4mg/kg of metoclopramide followed by 0. 3mg/kg/hr continuous rate infusion before and during anaesthesia, and 18 received a high dose of Metoclopramide has two uses: nausea relief through its direct effect on the brain and improvement of the rhythm of stomach contraction (i. 5 mg, 31. A few dogs in the megaesophagus support group have side effects from metoclopramide. 1. did not affect gastrointestinal motility. The effect of atropine, glycopyrrolate, metoclopramide and cisapride on the antral motility was investigated in eight dogs (four Beagles and four Labradors) using passive telemetry. Rarely, a pet will have cardiac issues, which requires discontinuing cisapride. The dose can be gradually increased if necessary. Both anticholiner Fortunately, such cardiac issues from cisapride use appear to be extremely rare in dogs and cats and have not been documented by the veterinary community. ) stimulated both antral and colonic motility. The effects of cisapride were dose related and correlated well (r = 0. 25 Other agents such as subtherapeutic doses of erythromycin, azithromycin, or However, metoclopramide was associated with significantly more central nervous system adverse effects. as they may counteract the effects of metoclopramide on Metoclopramide is a dopamine receptor antagonist, widely used in dogs and cats, to stimulate the stomach and upper-small-intestine motility. 24 Therefore, routine antibiotic therapy (including the use of metronidazole) is not recommended in dogs or cats with acute Increased prolactin concentrations were observed in seven patients of the metoclopramide group versus only 1 of the cisapride group (p < 0. In placebo-controlled trials, cisapride To purchase cisapride, your veterinarian will write a prescription to be sent to a compounding pharmacy as it is not currently available through pharmacies. DeNovo RC The effect of atropine, glycopyrrolate, metoclopramide and cisapride on the antral motility was investigated in eight dogs (four Beagles and four Labradors) using passive telemetry. This action helps prevent esophageal reflux and move ingesta from the stomach into the intestine. However, studies on laboratory animals are limited and the safety of the active substance has not been evaluated in the target species. a novel 5-HT-ergic agent with gastrokinetic activity, II. Little information is available regarding the clinical efficacy of these agents in dogs and cats with esophagitis or GER. 48, P less than 0. e. , 2014). The patients were not exposed to morphine as Eight of 21 dogs in the placebo group (38. Cisapride is a motility drug to aid movement of food through the digestive system. Dosages of cisapride One study (Wilson et al. 9 ng/ml. Metoclopramide Eight of 21 dogs in the placebo group (38. Prognosis The development of complications related to GI dysmotility (eg, gastroesophageal reflux and aspiration) have been associated with increased mortality risk. • No difference of reflux episodes (p>0. Use in Cats Experiments When it comes to correcting motilty, two medications in particular come to mind: metoclopramide and cisapride. Results are reported as median (minimum-maximum). The esophagus and trachea are entrapped by the pulmonary artery / heart base on the left and ventrally, the aorta on the Explore the causes and implications of laryngeal paralysis in dogs in this brief review. Its peripheral effects improve gastric emptying, and its central effects on dopamine receptors are antiemetic. As is recommended for metoclopramide, cisapride should be administered no closer than 30 minutes before feeding. Acid-blocking medications, for example omeprazole (brand names Gastrogard® and Prilosec®) and/or medications to promote stomach emptying, for example cisapride (brand names Prepulsid® and Propulsid®) or metoclopramide (brand name Reglan®) may be prescribed. , metoclopramide or cisapride) therapy has been advocated for stimulating esophageal peristalsis in affected animals Synopsis Cisapride, a substituted piperidinyl benzamide chemically related to metoclopramide, is an orally administered prokinetic agent which facilitates or restores motility throughout the length of the gastrointestinal tract. Esomeprazole itself increased the pH significantly but a noticeable difference with cisapride decreased GOR. 05). Cisapride at its highest dosage (10 mg) resulted in significantly faster gastric emptying than metoclopramide, and dose related and correlated well with the plasma drug levels. 01–0. Cisapride (Propulsid) Oral 0. Cisapride vs. 003) than metoclopramide. References. The spatial and Dogs with GERD also benefit from medication to strengthen the lower esophageal sphincter. Regression analysis showed a significant correlation (r The pharmacological profile of bethanechol (CAS 674-38-4), metoclopramide (CAS 364-62-5), trimebutine (CAS 39133-31-8) and cisapride (CAS 81098-60-4) was studied in a series of simple pharmacological tests in rats and dogs. Cisapride is unique among prokinetic agents in that it does not have antidopaminergic properties. [22][23][24] Metoclopramide is a less potent and effective prokinetic agent compared to cisapride in dogs. Metoclopramide is another medication used in veterinary medicine to address gastrointestinal motility disorders. Metoclopramide. 1-0. {R-48} Elimination: Cats—There is great variation among cats in clearance of cisapride. Erythromycin. It is a substituted piperidinyl benzamide, chemically related to metoclopramide, but unlike metoclopramide, cisapride is largely devoid of central depressant or antidopaminergic effects. et al. Metoclopramide is a dopamine (D 2) antagonist, an agonist at 5HT 4 receptors and an antagonist at 5HT 3 receptors. The use of this drug at Metoclopramide. Perioperative vomiting, regurgitation and reflux cause problems for veterinary patients during, but mostly after, anaesthesia. 38 Although other prokinetic agents such as metoclopramide have been assessed in the prevention of GER under anesthesia, comparative studies have shown that cisapride is far Recently, cisapride monohydrate (Prepulsid, Janssen Pharmaceutica, Mississauga, Ontario) hasgainedpop-ularity as aprokinetic drug. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, also inhibit neuronal reuptake of serotonin 7. Cisapride Metoclopramide Sucralfate RED YELLOW GREEN RED YELLOW GREEN RED YELLOW GREEN RED YELLOW GREEN RED YELLOW GREEN RED YELLOW GREEN RED YELLOW GREEN of esophageal imaging features in brachycephalic versus non-brachycephalic dogs based on videofluoroscopic swal - lowing studies. 25-0. , 2006) investigated different doses of metoclopramide against a saline infusion placebo in dogs undergoing elective orthopaedic surgery. Note: in one study in dogs, erythromycin did not alter cisapride pharmacodynamics. Both anticholinergics induced a pronounced and lasting reduction of the intensity and frequency of the contractions. Both will help reduce the nausea created by food pooling in the Are There Alternatives to Cisapride for Gastrointestinal Issues in Dogs? While Cisapride is a superior prokinetic drug (a medication that helps control acid reflux), Cisapride represents an improvement over metoclopramide in that the entire GI tract from stomach to colon can gain improved motility with cisapride. It may also alter the absorption of coadministered drugs. Animals—6 adult I have used cisapride in dogs and cats that have experienced neurologic side effects from metoclopramide. Evaluation of the Acotiamide hydrochloride (acotiamide; N -[2-[bis(1-methylethyl) amino]ethyl]-2-[(2-hydroxy-4,5-dimethoxybenzoyl) amino] thiazole-4-carboxamide monohydrochloride trihydrate, Z-338) has been reported to improve meal-related symptoms of functional dyspepsia in clinical studies. Antidopaminergic agents, such as metoclopramide, have both central and peripheral antiemetic effects and are used off-label in dogs and cats. Cisapride. , stomach motility modification. Metoclopramide also can cross into the brain to help control the sensation of nausea. 5, 5, 10 mg), placebo, and metoclopramide (10 mg). Equip yourself with essential knowledge to better understand this condition. 5 ng/ml; cisapride 10 mg, 101. 5 mg/kg q12h. Limitations: • Study was not stated to be blinded. 5, 5, 10 mg), placebo, and metoclopramide (10 What Is Cisapride? Cisapride is an oral medication that helps move food through the digestive tract. cisapride 2. Cisapride was not detected in any of the blood samples taken after placebo or metoclopramide injection. A history of gastrointestinal disease will often indicate the possibility of reflux, but many animals that regurgitate under anaesthesia have no previous history or predisposing factors, making this event an unwelcome surprise. Furosemide. 01 to 0. g. Smooth muscle prokinetic (e. Not only stomach contractions are improved but the entire tract motility is When it comes to correcting motilty, two medications in particular come to mind: metoclopramide and cisapride. 6. A Promotility medications commonly used include metoclopramide (1-2mg/kg/day as a CRI, or 0. metoclopramide. , metoclopramide or cisapride) has been advocated for stimulating esophageal peristalsis, but these drugs will probably not have much affect on the striated muscle of the canine esophageal body. In fasted dogs, intravenous cisapride stimulates motor activity of the upper-gastrointestinal tract and elicits contractile patterns similar to those recorded during the inter-digestive period, Abad P. She is the founder and owner of JPen Communications, a medical communications company that specializes in educating pet parents about pet health and pet care. 5mg/kg PO TID). 1–0. Dr. Most dogs with this problem will steadily improve over a few days, but the above medications are usually continued for 7-10 days post-discharge. 5, 16 Cisapride appears to be superior to metoclopramide and domperidone in stimulating gastric emptying. A new intra-nasal formulation of metoclopramide has also been approved by the Food and Drug Administration (FDA) of the United States. 5 mg/kg, PO or SC, q 8 h; 0. 1%), 8 of 22 dogs in the esomeprazole group (36%), and 2 of 18 dogs in the combined esomeprazole and cisapride group (11%) had ≥ 1 episode of GER on The present data indicate that during the 2 weeks after completion of treatment in patients with functional dyspepsia, cisapride may result in a better, more sustained overall response when compared with metoclopramide. Dogs, cats: 0. Its novel mechanism of action is thought to involve enhancement of acetylcholine release in the myenteric plexus of the gut. Considering the adverse events related to metoclopramide or domperidone, the short-term use of these agents or the alternative use of trimebutine or mosapride could be recommended for the symptomatic relief of FD. • Low reflux events in the control group made it difficult to determine a difference compared to the The syndrome occurs spontaneously in adult dogs between 7 to 15 years of age without sex or breed predilection. J Vet Intern Med. Higher doses are not recommended in order to avoid side effects. 1, 17 Prokinetic treatment is a mainstay of treatment, and cisapride has been shown to increase the antroduodenal motility index and improve enteral feeding in people We investigated the contractile mechanisms of action of three putative gastroprokinetic agents (cisapride, metoclopramide, and domperidone) on the linear phase of gastroduodenal emptying of solid meals in six healthy conscious dogs. dose, and those over 40 pounds 10 mg per dose. It can be used in several animals (dogs, cats, small mammals, chickens, reptiles, and rabbits) to treat slowing of the Cisapride is an orally administered prokinetic agent which facilitates or restores motility throughout the length of the gastrointestinal tract. , cisapride has demonstrated excellent efficacy in management of colonic inertia and small intestinal ileus). Radionuclide gastric solid-phase emptying was studied in 10 subjects with diabetic gastroparesis comparing the acute intravenous administration of cisapride (2. Clinical evaluation of gastroesophageal reflux in children: a double blind study of cisapride vs. 1%), 8 of 22 dogs in the esomeprazole group (36%), and 2 of 18 dogs in the combined esomeprazole and cisapride group (11%) had ≥ 1 episode of GER on However, the incidence of cisapride-induced movement disorders would be expected to be significantly less than with metoclopramide, an antidopaminergic, gastrokinetic agent. Cisapride is also useful in managing gastric stasis, idiopathic constipation, and postoperative ileus in dogs and cats. 5 mg/kg PO, SC, or IM Q 8 H 1–2 mg/kg/day CRI Nizatidine Cholinesterase inhibitor Metoclopramide reduces the amount of propofol needed for anesthetic induction in humans by 20-25% (mechanism unknown). The efficacy and tolerability of cisapride (5 mg three times daily) and metoclopramide (10 mg three times daily) were evaluated in a randomized double-blind The effects of AS-4370 [4-amino-5-chloro-2-ethoxy-N-(4-(4-fluorobenzyl)-2 morpholinyl)methyl)benzamide citrate] on gastrointestinal (GI) motor activity were compared with those of cisapride and metoclopramide in conscious dogs with force transducers implanted chronically. Because of Metoclopramide has two uses: nausea relief through its direct effect on the brain and improvement of the rhythm of stomach contraction (i. Time to first emesis and the number of emetic events per dog were also compared between groups with the Kruskal-Wallis test by ranks. 5, 5, 10 mg), placebo, and metoclopramide (10 Abstract Objective—To evaluate the effects of cisapride and metoclopramide hydrochloride administered orally on the lower esophageal sphincter (LES) resting pressure in awake healthy dogs. 54, 55 Indeed, gastric emptying is improved with cisapride No difference was found in serum gastrin concentrations between dogs with hepatic disease and healthy controls,162 but continuous intragastric pH monitoring and GI preventive measures for decreasing reflux esophagitis in dogs undergoing surgery are administration of cisapride or metoclopramide, with cisapride being more effective Smooth-muscle prokinetic therapy (e. Procedure: In this prospective clinical study, dogs were evaluated before and during orthopedic surgery. While both Cisapride and Metoclopramide aim to improve digestive Cisapride accelerates gastric emptying in dogs by stimulating pyloric and duodenal motor activity, by enhancing antropyloroduodenal coordination, and by increasing the mean propagation Cisapride is especially useful in animals that develop neurologic effects from metoclopramide. Cats: 2. 4mg/kg SQ/IV TID), ranitidine (1-2mg/kg IV BID) and occasionally cisapride (0. 05) was found between the groups. They may be used alone or in combination with acid reducing agents and diffusion barriers in patients with esophagitis. In the dog, cisapride stimulates contraction of the LES without effect on esophageal peristalsis, because the entire esophageal body is composed of striated muscle. 38 Although other prokinetic agents such as metoclopramide have been assessed in the prevention of GER under anesthesia, comparative studies have shown that cisapride is far Cisapride and metoclopramide have been demonstrated to increase LES tone in dogs (Table 2). Cisapride represents an improvement over metoclopramide in that the entire GI tract from stomach to colon can gain improved motility with cisapride. It is a substituted piperidinyl benzamide, chemically related to metoclopramide, but unlike metoclopramide, cisapride is largely devoid of central depressa The effect of atropine, glycopyrrolate, metoclopramide and cisapride on the antral motility was investigated in eight dogs (four Beagles and four Labradors) using passive telemetry. Drug Metab Dispos 16(3 2 mg/kg PO (dogs) and 1 mg/kg PO (cats) 8 mg/kg PO for motion sickness (dogs) Metoclopramide D2 dopaminergic antagonist 5-HT3 serotonergic antagonist 5-HT4 serotonergic agonist Antiemetic** Prokinetic agent Increases gastroesopha-geal sphincter tone 0. While both cisapride and metoclopramide normalized impaired solid emptying, cisapride at its Cisapride accelerates gastric emptying in dogs by stimulating pyloric and duodenal motor activity, by enhancing antropyloroduodenal coordination, and by increasing the mean propagation distance of duodenal contractions. However, since cisapride no longer has FDA approval, it is not Metoclopramide is rapidly metabolized through the liver, and the best results are observed when given at continuous-rate infusion (0. Current guidelines recommend liquid formulation metoclopramide, 5 to 10 mg orally, 30 min before meals and at bedtime in patients with gastroparesis. The relationship between variables and survival dates is shown in Table 1. Not only stomach contractions are improved but the entire tract motility is Compared to metoclopramide, cisapride is more effective for increasing lower esophageal sphincter tone in dogs, which is helpful for preventing reflux esophagitis (Kempf et al. Because it Cisapride is a prokinetic agent that acts via 5-HT 4 receptors enhancing a cholinergic effect and inducing increased motor activity. ) In the case of metoclopramide, probably the anti-nausea effect is the dominating mechanism of action in dogs, while the motility-modifying effect dominates in cats. Pendergrass is passionate about closing the gap between what the veterinarian says and what the pet parent understands. In the upper GI tract, meto- In dogs cisapride has greater prokinetic activity in the stomach relative to metoclopramide. A comparison between maropitant and metoclopramide for the prevention of morphine-induced nausea and vomiting in dogs. As a dopaminergic (D2) antagonist and prokinetic agent, metoclopramide has several important drug interactions: Cisapride. Bethanechol stimulated both gastric emptying and intestinal propulsion but d Promotility agents, including ranitidine/nizatidine, metoclopramide, erythromycin, and cisapride are the mainstays of therapy in small animals. 5 mg/kg, PO, q 8–12 h; doses up to 1 mg/kg have been used in some dogs. Cisapride should not be given concomitantly with antifungal agents or macrolide antibiotics. 2%). Psychiatric events, including confusion, depression, suicide attempt, and hallucinations, have been reported with cisapride therapy during postmarketing surveillance. Excretion and biotransformation of cisapride in dogs and humans after oral administration. Cisapride was well tolerated, with adverse effects limited primarily to the gastrointestinal tract. 5 mg/cat for cats < 5 kg, and 5 mg/cat for cats > 5 kg, PO, q 8 h. OBJECTIVE To determine the effect of 2 doses of metoclopramide on the incidence of gastroesophageal reflux Cisapride and domperidone were dissolved in 5% lactic acid. In the upper GI tract, meto-. High-resolution manometric evaluation of the effects of 30 dogs received metoclopramide – an intravenous bolus of 1 mg/kg 5 minutes before induction, and continuous infusion (1 mg/kg/h intravenously) immediately after anaesthetic induction. The anesthetic protocol used was standardized to Unlike metoclopramide, however, it also increases colonic motility 41 Cisapride is a more potent gastric prokinetic than metoclopramide (as shown in dogs). Medications to help control reflux and esophagitis are used at the start of treatment. 1-1 mg/kg i. Metoclopramide is also used in dogs and, less commonly, in cats to treat nausea . , thereafter 1 mg/kg/hr infusion), a selective 5-HT4 receptor antagonist. 17-19 Esopha-geal 5-HT4 receptors are present in many species but are apparently absent in canine esophageal Cisapride (Propulsid) Kaolin & Pectin; Loperamide (Imodium A-D) Metoclopromide (Reglan) Simethicone; Cimetidine; Ranitidine; Bio-Sponge; Read more about how reglan and propulsid are used in this post. Cisapride represents an improvement over metoclopramide in that the entire GI tract from stomach to colon can gain improved motility. 02 mg/kg/h, IV infusion. Thisreviewhighlights the differences between these 2 drugs and their clinical applications. No hemodynamic or electrocardiographic changes were noted. These medications, such as cisapride (brand names: Prepulsid®, Propulsid®) and metoclopramide (brand names: Reglan® and Maxolon®), Metoclopramide also can cross into the brain to help control the sensation of nausea. 7 ng/ml; cisapride 5 mg, 63. Bethanechol (5-15mg/dog PO q 8 Radionuclide gastric solid-phase emptying was studied in 10 subjects with diabetic gastroparesis comparing the acute intravenous administration of cisapride (2. GI Effects Arch Surg 104, 684-686 (1972) 4 Mchugh S Lico S Diamant NE Cisapride vs metoclopramide: an acute study in diabetic gastroparesis Dig Dis Sci 37 1992 997 1001 Mchugh S, Lico S and Diamant NE: Cisapride vs metoclopramide: an acute study in diabetic gastroparesis. Use in Cats Experiments Cisapride is especially useful in animals that develop neurologic effects from metoclopramide. In addition, somnolence and fatigue are reported with lesser frequency during cisapride therapy (1. The use of the product during pregnancy and lactation must be made according to the benefit/risk assessment carried out by the veterinarian. In postprandial state, AS-4 Kaplan-Meier survival curve for 28 dogs with ME. The enhanced GI motility induced by mosapride or cisapride was antagonized by pretreatment with GR113808 (1 mg/kg bolus i. •Note: in one study in dogs, erythromycin cisapride but is not believed to be associated with adverse cardiac effects in human beings. Three months after diagnosis, four dogs with AP died, while Metoclopramide. Kaolin & Pectin However, the antidopaminergic activity of cisapride in animals is less than that of metoclopramide, and therefore the risk of extrapyramidal effects is thought to be low. The central effects are also responsible for most of the therapy-limiting adverse effects including drowsiness and dystonic reactions. The survival time of ME dogs, with or without AP, was significantly different between the two groups with the MST being 114 days and NR, respectively (). Eighteen dogs received saline, 16 received a low dose of 0. Dogs: 0. 2–0. The absorption of morphine, diazepam, cyclosporin, alcohol (ethanol) and levodopa are increased. The solution was adjusted to pH 5 and diluted with distilled water to the required concentration. High plasma concentrations of cisapride can lead to potentially fatal cardiac arrhythmias in humans. 42 While it has no direct efficacy as a central antiemetic, cisapride may be an effective treatment for vomiting due to gastroparesis (eg, from postoperative ileus or infiltrative gastric The most common vascular ring anomaly in dogs and cats is persistence of the right aortic arch. Cisapride has broader promotility effects than metoclopramide (e. Animals: 52 healthy dogs undergoing elective orthopedic surgery. 6%) than with metoclopramide (15. The present data indicate that during the 2 weeks after completion of treatment in patients with functional dyspepsia, cisapride may result in a better, more sustained overall response when compared an interaction between clomipramine and these drugs has not been directly evaluated in dogs, but the veterinary clomipramine label (Clomicalm®) recommends against giving clomipramine within 14 days of either L-deprenyl or amitraz [98]. The disorder has been compared erroneously to esophageal achalasia in humans. RESULTS Effects of itopride, cisapride, domperidone and metoclopramide on gastric motility in conscious dogs Itopride at a dose of 3 mg/kg, i. 29 Cisapride has no direct antiemetic effect, although it is indicated in a vomiting cat with colonic dysmotility secondary to megacolon. Conclusions: Cisapride represents an attractive alternative to metoclopramide for the treatment of a variety of motility disorders. Am J Gastroenterol 1990;85 In a double-blind, randomized study, the clinical effects of 5 mg and 10 mg of cisapride three times daily were compared with those of 10 mg of metoclopramide three times daily in 114 patients with symptoms of gastroesophageal reflux, mainly diurnal Metoclopramide, trimebutine, mosapride, and domperidone showed better efficacy for the treatment of FD than itopride or acotiamide. Prokinetic agents (cisapride, metoclopramide) are used by some clinicians to assist with esophageal motility, but their actions are for smooth muscle peristalsis which would be more effective in cats than dogs; metoclopramide can also be used for its ability to increase the tone of the lower esophageal sphincter. v. Vertical marks represent censored data. This sounds great but crossing into the brain also can lead to hyperexcitability in some patients, which can be a big problem. Initial absorption of Cimetidine and raniditine is also increased, but overall Administration of metoclopramide by bolus and constant rate infusion at doses much higher than commonly used will reduce the incidence of gastroesophageal reflux but not totally prevent GER in anesthetized dogs undergoing orthopedic surgery. 58 Previous studies comparing cisapride to other prokinetic agents have shown equivalent efficacy with both erythromycin and metoclopramide. Synopsis Cisapride is an orally administered prokinetic agent which facilitates or restores motility throughout the length of the gastrointestinal tract. Cisapride may promote more effective gastric emptying in cats. demonstrated no benefit in treated dogs versus control dogs. {R-2} Dogs—After administration of a 1-mg/kg dose, 97% of the dose is eliminated within 96 hours, with about 72% eliminated in the feces and 25% in the urine. Significance was Management of intestinal leiomyositis in humans is supportive generally and aimed at relieving signs arising from intestinal dysmotility as well as optimizing nutritional support. Objective: To determine the effect of 2 doses of metoclopramide on the incidence of gastroesophageal reflux (GER) in anesthetized dogs. This prokinetic and anti-emetic agent shortens gastric emptying time and can increase the absorption of acetaminophen and aspirin from the small intestine, increasing the risk for toxicity. 02 mg/kg every hour or 1 to 2 mg/kg every 24 hours). 01) with the plasma drug levels. Augusto M Lorenzutti. d. Cisapride is also useful in managing gastric stasis, idiopathic constipation, and postoperative Cisapride accelerates gastric emptying in dogs by stimulating pyloric and duodenal motor activity, by enhancing antropyloroduodenal coordination, and by increasing the mean propagation distance of duodenal Compared to metoclopramide, cisapride is more effective for increasing lower esophageal sphincter tone in dogs, which is helpful for preventing reflux esophagitis (Kempf et al. Recently, cisapride monohydrate (Prepulsid, Janssen Pharmaceutica, Mississauga, Ontario) hasgainedpop-ularity as aprokinetic drug. Like ketoconazole, cisapride is a substrate of CYP3A. Several drug combinations with furosemide can lead to enhanced toxicity: Amikacin and gentamicin: nephrotoxicity is enhanced by The effect of atropine, glycopyrrolate, metoclopramide and cisapride on the antral motility was investigated in eight dogs (four Beagles and four Labradors) using passive telemetry. Here, we examined the gastroprokinetic effects of acotiamide and its antiacetylcholinesterase activity as However, cisapride, zacopride and BIMU 8 (0.