Which medications in the drug class Prokinetic Agents are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Updated: Sep 01, 2021
  • Author: Bennie Ray Upchurch, III, MD, FACP, AGAF, FACG, FASGE; Chief Editor: BS Anand, MD  more...
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Answer

Prokinetic Agents

The use of the prokinetics agent to empty the stomach of retained blood or clots to improve endoscopic visualization has been extensively studied. To date, four large randomized controlled trials and three meta-analyses have shown that erythromycin reduces the need for second-look endoscopy but did not significantly reduce clinical outcomes such as blood transfusions, hospital stay, or surgery. [158, 159, 160, 161, 162, 163, 164]

Metoclopramide (Metozolv ODT, Reglan)

Metoclopramide blocks dopamine receptors (at high dose) and serotonin receptors in chemoreceptor trigger zone of the CNS; and sensitizes tissues to acetylcholine; increases upper GI motility but not secretions; increases lower esophageal sphincter tone.

Erythromycin ethylsuccinate (E.E.S., EryPed)

The prokinetic action of the macrolide antibiotic erythromycin is related to its action as a motilin-receptor agonist in the gut and gallblader to stimulate the GI tract.


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