Gastrointestinal prokinetic therapy: Motilin-like drugs

Although motility disorders of the esophagus, stomach, small intestine, and colon in cats and dogs are traditionally treated mainly by dietary management and surgical intervention, gastrointestinal prokinetic therapy is increasingly important in practice. The first four parts of this five-part Continuing Education Series group gastrointestinal prokinetic drugs into four categories; for each category, the mechanisms of action, site of activity, and indications are considered. Part I provided information concerning the dopaminergic antagonist drugs. Part II deals with motilin-like drugs, particularly erythromycin and the other macrolides. Since the antibiotic properties of these drugs were discovered, erythromycin has been used widely to treat bacterial and mycoplasmal infections. The side effects of this therapy on gastrointestinal motility have led to the conclusion that erythromycin may be a useful gastrointestinal prokinetic agent. The third article in this series will discuss serotonergic drugs. Part IV will deal with the acetylcholinesterase inhibitors or parasympathetic potentiating drugs. The concluding article will consider the diagnosis and treatment of esophageal, gastric, and colonic motility disorders.