Severe gastroparesis: New treatment alternatives

Abrahamsson, Hasse

doi:10.1016/j.bpg.2007.03.008

Cited by 11 publications

(6 citation statements)

References 46 publications

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“…It has half life of 6 h, so there is a need for frequent administration and bioavailability can be improved by making the drug completely absorbed in the stomach and upper part of the small intestine. 5,6 It activates the gastrointestinal motility through synergism of its dopamine D2 receptor antagonistic action and acetylcholine esterase-inhibitory action. In addition to these actions, ITO has an antiemetic action, which is based on its dopamine D2 -receptor antagonistic action.…”

Section: Introductionmentioning

confidence: 99%

Controlled Release Ion Sensitive Floating Oral in situ Gel of a Prokinetic Drug using Gellan Gum.

Rao¹,

Shelar²

2015

IJPER

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There are various approaches commonly used for gastric retention, one of which is raft forming system. Floating oral in situ gel is a type of raft forming system. The present work concerns with the formulation, evaluation and optimization of floating oral in situ gel of Itopride Hydrochloride for controlled release. Gellan gum has been used as a gel forming polymer and calcium carbonate as cross linking agent and Ca 2+ ion source, and HPMC K100M as release retardant. The floating oral in situ gel undergoes gelation by ion sensitive mechanism. In this formulation 3 2 factorial designs was performed and the effect of variation in concentration of gellan gum and HPMC K100M on drug release at 1 h, 6 h, and viscosity was evaluated. The gel was evaluated for other parameters like floating lag time, floating duration, gel strength, density, pH, in vitro drug release, drug content, and in vitro gelling capacity. The results of 3 2 full factorial design revealed that the concentration of gellan gum and of HPMC K100M significantly affected the dependent variables i.e. drug release at 1 h, at 6 h, and viscosity. A controlled release profile was observed for these formulations. The drug release mechanism was found to follow Korsmeyer-Peppas model. In vivo studies revealed higher T max of gel compared to plain drug which is suggestive of slower absorption. However the AUC 0-12 h was found to be nearly 90% higher than plain drug.

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Section: Introductionmentioning

confidence: 99%

Controlled Release Ion Sensitive Floating Oral in situ Gel of a Prokinetic Drug using Gellan Gum.

Rao¹,

Shelar²

2015

IJPER

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“…Erythromycin and low dose tricyclic antidepressants have also been employed with some success, but erythromycin commonly causes diarrhea and tricyclics may cause anti-cholinergic effects that enhance symptoms. More invasive management strategies include implantation of a gastric electric stimulator, which has been shown to improve nausea and vomiting within six weeks of therapy, and botulinum toxin injection is continually being investigated for efficacy [8,9]. Despite these options, there remains a clear need to look at other potential medications for gastroparesis.…”

Section: Introductionmentioning

confidence: 99%

Mirtazapine treatment of diabetic gastroparesis as a novel method to reduce tube-feed residual: a case report

Gooden

Takahashi

2013

J Med Case Reports

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IntroductionGastroparesis is a common motility disorder that is characterized by delayed gastric emptying in the absence of mechanical obstruction. Diabetes, along with other neuromuscular and infiltrating disorders, can predispose individuals to an increased risk of developing gastroparesis. Gastroparesis can be easily diagnosed through gastric emptying studies but is usually difficult to successfully treat. Therapy usually begins with pro-kinetic and anti-emetic agents.Case presentationOur patient was an 87-year-old African-American woman who was a nursing home resident, with a history of diabetes mellitus type 2 and subarachnoid hemorrhage leading to aphasia, hemiplegia, seizures and dysphagia requiring percutaneous gastric feeds. While at the nursing home, she had recurrent aspiration pneumonia and large tube-feed residuals consistent with a diagnosis of underlying gastroparesis. Her management included metoclopramide and reduced tube-feeding rates, which improved her symptoms. However, within months the aspiration and increased residuals returned. After trials of different medication therapies without success, she started mirtazapine and her residual volume and aspirations decreased with a dose of 15mg nightly.ConclusionIn patients with gastroparesis recalcitrant to first line therapies such as metoclopramide, off-label use of mirtazapine may provide adequate non-invasive management of gastroparetic symptoms.

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“…gastric electrical stimulation and ⁄ or jejunostomy). [14][15][16] Thus, there is an unmet medical need for a well-tolerated pharmacological option that alleviates severe nausea and vomiting. TZP-101 (ulimorelin) is a first-in-class macrocyclic peptidomimetic with potent binding affinity for the ghrelin receptor, also known as the growth hormone secretagogue receptor (hGHS-R1a).…”

Section: Resultsmentioning

confidence: 99%

Randomised clinical trial: ghrelin agonist TZP-101 relieves gastroparesis associated with severe nausea and vomiting - randomised clinical study subset data

Ejskjær²,

Hellström

et al. 2011

Alimentary Pharmacology &Amp; Therapeutics

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Severe gastroparesis: New treatment alternatives

Cited by 11 publications

References 46 publications

Controlled Release Ion Sensitive Floating Oral in situ Gel of a Prokinetic Drug using Gellan Gum.

Controlled Release Ion Sensitive Floating Oral in situ Gel of a Prokinetic Drug using Gellan Gum.

Mirtazapine treatment of diabetic gastroparesis as a novel method to reduce tube-feed residual: a case report

Randomised clinical trial: ghrelin agonist TZP-101 relieves gastroparesis associated with severe nausea and vomiting - randomised clinical study subset data

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