Sequential single doses of cisapride, erythromycin, and metoclopramide in critically ill patients intolerant to enteral nutrition: A randomized, placebo-controlled, crossover study

MacLaren, Robert; Kuhl, David A.; Gervasio, Jane M.; Brown, Rex O.; Dickerson, Roland N.; Livingston, Teresa N.; Swift, Kyle; Headley, Stacey; Kudsk, Kenneth A.; Lima, John J.

doi:10.1097/00003246-200002000-00025

Cited by 98 publications

(66 citation statements)

References 56 publications

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“…In previous studies comparing metoclopramide and erythromycin as a prokinetic agent, erythromycin has been found to be equivalent to metoclopramide [27,28].…”

Section: Discussionmentioning

confidence: 96%

Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume

Bala¹,

Prasad²,

Bhukal³

et al. 2008

Journal of Clinical Anesthesia

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“…In previous studies comparing metoclopramide and erythromycin as a prokinetic agent, erythromycin has been found to be equivalent to metoclopramide [27,28].…”

Section: Discussionmentioning

confidence: 96%

Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume

Bala¹,

Prasad²,

Bhukal³

et al. 2008

Journal of Clinical Anesthesia

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“…This contributes to the insufficient intake of calories and greater postoperative complications, further adding to cost of treatment (10)(11)(12). In order to treat gastric hypo motility and intolerance, pro-motility drugs and small bowel tube feeding were used (13)(14)(15). However, in routine clinical use, bearing in mind economic and rational approach, and also to avoid side effects, pro-motility drugs are exclusively used in treating already existing gastric intolerance but not for the prevention of postoperative gastric hypomotility (13,14).…”

Section: Discussionmentioning

confidence: 99%

“…In order to treat gastric hypo motility and intolerance, pro-motility drugs and small bowel tube feeding were used (13)(14)(15). However, in routine clinical use, bearing in mind economic and rational approach, and also to avoid side effects, pro-motility drugs are exclusively used in treating already existing gastric intolerance but not for the prevention of postoperative gastric hypomotility (13,14). The post-pyloric placement of feeding tube requires certain clinical experience and is technically demanding and time-consuming.…”

Section: Discussionmentioning

confidence: 99%

Early postoperative gastric enteral nutrition improves gastric emptying after noncomplicated cardiac surgery

Šustić

Zelić

Medved

et al. 2006

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“…Cisapride is the most well known agent in this class, and has dual stimulatory effects on the 5-Hydroxytryptamine (5-HT4) serotonin receptors and the parasympathetic nervous system, leading to increases in both 5-HT4 and acetylcholine in the enteric nervous system. The use of cisapride has been shown to associate with improved gastric emptying in critically ill patients as well as reduced the occurrence of feed intolerance [38][39][40][41][42] . Due to case reports of cisapride induced lethal cardiac toxicity [43] , however, the drug has been withdrawn and is not available for clinical use.…”

Section: Serotonin (5-hydroxytryptamine) Receptor Agonistsmentioning

confidence: 99%

Pharmacological therapy of feed intolerance in the critically ills

Nguyen¹

2014

WJGPT

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Feed intolerance in the setting of critical illness is associated with higher morbidity and mortality, and thus requires promptly and effective treatment. Prokinetic agents are currently considered as the first-line therapy given issues relating to parenteral nutrition and postpyloric placement. Currently, the agents of choice are erythromycin and metoclopramide, either alone or in combination, which are highly effective with relatively low incidence of cardiac, hemodynamic or neurological adverse effects. Diarrhea, however, can occur in up to 49% of patients who are treated with the dual prokinetic therapy, which is not associated with Clostridium difficile infection and settled soon after the cessation of the drugs. Hence, the use of prokinetic therapy over a long period or for prophylactic purpose must be avoided, and the indication for ongoing use of the drug(s) must be reviewed frequently. Second line therapy, such as total parenteral nutrition and post-pyloric feeding, must be considered once adverse effects relating the prokinetic therapy develop.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Adverse effects; Critical illness; Enteral feeding; Feed intolerance; Prokinetic therapyCore tip: Feed intolerance during critical illness must be promptly recognized and treated due to the associated morbidity and mortality. The current first line treatment for feed intolerance is prokinetic therapy with erythromycin and metoclopramide (alone or in combination), which are highly effective and free of significant adverse effects. Although diarrhoea occurs commonly after combination prokinetic therapy, it is not associated with Clostridium difficile colitis and settled shortly after stopping the treatment. The use of prokinetic therapy over a long period or for prophylactic purpose, therefore, must be avoided and the indication for ongoing use of the drug(s) should be frequently reviewed.Nguyen NQ. Pharmacological therapy of feed intolerance in the critically ills.

show abstract

Sequential single doses of cisapride, erythromycin, and metoclopramide in critically ill patients intolerant to enteral nutrition: A randomized, placebo-controlled, crossover study

Cited by 98 publications

References 56 publications

Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume

Effect of preoperative oral erythromycin, erythromycin-ranitidine, and ranitidine-metoclopramide on gastric fluid pH and volume

Early postoperative gastric enteral nutrition improves gastric emptying after noncomplicated cardiac surgery

Pharmacological therapy of feed intolerance in the critically ills

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