Bɛlɛ de pwɛl? Yu nɔ ebul fɔ dayjɛst it? Kam, mek wi tɔk bɔt (Prokinetic Agents)!

Sɔntɛnde yu kin fil ful ɔ yu nɔ de digest it fayn afta yu dɔn it? Ɔ yu gɛt prɔblɛm dɛn lɛk at bɔn ɔ yu nɔ de it fayn? Sɔntɛnde, dɛn prɔblɛm ya kin kam bikɔs wi intestinal nɔ de wok fayn. Tide wi go tɔk bɔt wan spɛshal kayn mɛrɛsin we kin kam fɔ ɛp dɛn kayn tɛm ya. Dɛn kɔl dɛn tin ya `(Prokinetic Agents)`.

Wetin na dɛn `(Prokinetic Agents)` ya? Fɔ tɔk am simpul wan...

Fɔ tɔk am simpul wan, `(Prokinetic Agents)` na wan kayn mɛrɛsin we de mek di it de muv kwik kwik wan tru yu dijestiv sistɛm, dat na di intestinal dɛm. We wi swɛla it, di mɔsul dɛn na wi dijestiv trakt kin bigin fɔ kɔntrakt frɔm ɔp to dɔŋ lɛk wan siriɔs wef. Dɛn kɔl dis `(Pɛristalsis)`. I tan lɛk se yu de push it dɔŋ. dis na aw di it de muv frכm di trot, dכn di εsophagus, go insay di bεlε, εn afta dat go insay di intestines. na insay dis joyn we wi bכdi de tek di nyutriεnt dεm we i nid.

Bɔt bikɔs ɔf sɔm sik ɔ ɔda rizin, dis prɔses we dɛn kɔl ``Pɛristalsis'' nɔ kin wok fayn. Dis na we di sayn dɛm lɛk kɔnstipɛshɔn, at bɔn, ɛn fil fɔ ful we yu nɔ digest it kin apin. Fɔd kin de na di bɛlɛ fɔ lɔng tɛm, dɔn di bɔdi nɔ kin gɛt di tin dɛn we i nid.

Na da tɛm de dɛn drɔgs ya we dɛn kɔl `(Prokinetic Agents)` kin kam fɔ ɛp. dis dεm de mek di intestכn dεm de muv εn de εp fכ it pas dכn di dijestiv trakt fast fast. Bɔt di tin we impɔtant pas ɔl fɔ mɛmba na dat , impɔtant sayd ɛfɛkt dɛn de we kin kam wit dɛn mɛrɛsin ya. So, bɔku tɛm, dɔktɔ dɛn nɔ kin gi dɛn mɛrɛsin ya wantɛm wantɛm. Bɔku tɛm, dɛn kin gi `(Proton Pump Inhibitors - PPIs)` ɔ `(H2 Blockers)` ɔda drɔgs ɛn afta dat dɛn kin tink bɔt `(Prokinetic Agents)` nɔmɔ if dɛn nɔ gi rilif. Bɔt i go dipen pan yu mɛrɛsin, yu dɔktɔ kin gi yu dis mɛrɛsin bak.

Aw dɛn `(Prokinetic Agents)` ya de wok?

Di we aw dɛn mɛrɛsin ya de wok kɔmplikt smɔl, bɔt a go kip am simpul. Dɛn kin jɔs mek di nɛv dɛn we de na yu dijestiv sistɛm wok ɛn ɛp di mɔsul dɛn fɔ kɔntrakt.

Dat min se:

• I de mek yu εsophagus (fud paip) kכntrikshכn bכku, i de εp fכ muv it kwik kwik wan insay di bεlε.
• Strɔng di Lɔwa Ɛsophageal Sfincter (LES) we de dɔŋ yu εsophagus. Di LES tan lɛk valv. Na di pat pan yu εsophagus we de kכnekt yu bεlε to yu εsophagus. If i nɔ lɔk fayn ɛn i lɔs, di bɛlɛ asid kin kam bak ɔp insay yu εsophagus ɛn trot. Na da tɛm de yu kin gɛt da at-bɔn, at-bɔn, ɛn chɛst pen. Dɛn kin kɔl dis bak Asid Riflɔks ɔ GERD.
• I de mek di bɛlɛ kɔntrakt mɔ ɛn i de ɛp fɔ muv it kwik kwik wan insay di smɔl intestinal.
• I de ridyus di tɛm we i kin tek fɔ mek di bɛlɛ ɛmti. dis de ridyus di chans fכ di tin dεm we de insay di bεlε fכ kam bak כp, lεk di kes fכ `(Acid Reflux)`.

Imajin, dis mɛrɛsin de wok lɛk trafik jam, ɛn di polis dɛn kin kam ɛn klia di rod fɔ mek di motoka dɛn muf kwik kwik wan.

Fɔ us kɔndishɔn dɛn de yuz `(Prokinetic Agents)`?

Dɛn kin yuz dɛn mɛrɛsin ya mɔ fɔ dɛn sik ya:

• Gastroparesis (bכdi mכsul dεm nכ de wok fayn/di delay fכ digεst): Insay dis kכndyushכn, di bεlε mכsul dεm nכ de kכntrakt fayn, so di digεsshכn fכ it de delay. di prokinetic mεdikeshכn dεm de mek dεn kכntrikshכn dεm ya bכku εn mek di bεlε ɛmti kwik kwik wan. Pipul wae gɛt shuga kin gɛt dis sik bak wae dɛn kɔl Dayabitik Gastroparesis. Metoclopramide na di onli drɔg we di FDA na Amɛrika dɔn gri fɔ dis naw. Yu dɔktɔ kin gi yu dis if ɔda tritmɛnt dɛn nɔ ɛp yu.

• GERD (Gastroesophageal Reflux Disease): Dis na we di bɛlɛ asid de kam bak ɔp di εsophagus insay di mɔt. Dis kin apin we di LES (Lessive Esophageal Suppression System) we a bin dɔn tɔk bɔt nɔ kin lɔk fayn. Prokinetic agents nכmכ nכ go εp GERD. Bɔt if yu bɛlɛ slo fɔ ɛmti, yu dɔktɔ kin gi yu dɛn mɛrɛsin ya wit ɔda mɛrɛsin dɛn.

• Functional Dyspepsia: Dis na we yu bɛlɛ nɔ de fil fayn afta yu dɔn it, bɔt dɛn nɔ go ebul fɔ fɛn ɛni klia kɔz. Sɔm pipul dɛn kin si se dɛn mɛrɛsin ya kin ɛp fɔ ridyus di sayn dɛm. Risach pipul dɛn se dɛn mɛrɛsin ya kin ɛp bay we i kin mek di bɛlɛ kɔntrakt mɔ ɛn mɔ ɛn mek i ɛmti kwik kwik wan.

• Nɔs ɛn vɔmit: Dɔktɔ kin gi dis mɛrɛsin fɔ akyu ɔ krɛse vɔmit we nɔ dɔn ansa ɔda tritmɛnt dɛn. Sɔntɛnde dɛn kin yuz dɛn bak fɔ vɔmit we dɛn kin yuz kemotɛrapi drɔgs fɔ kansa.

• Chronic Intestinal Pseudo-obstruction: Dis na we di sayn dɛm fɔ blok de pan ɔl we nɔ rial blɔk de na di intestin . Risach pipul dεm stil de invεstigat if sכm prokinetic ejen dεm kin εp wit dis kכndyushכn.

Wetin na di men kayn `(Prokinetic Agents)`?

Dɛn kin sheb dɛn drɔgs ya to tu men kategori: `(Agonists)` ɛn `(Antagonists)`.

• `(Agonists)`: dεn ya de akt lεk sכm `(Neurotransmitters)` (kεmikכl dεm we de kכri mεsej bitwin nεv dεm) na wi nεv sεstem. dat min se, dεn `(Agonists)` dεm ya de go εn atak wan nεv, de tεl da nεv de fכ "kכntrakt". Jεs lεk aw di rilevεnt `(Neurotransmitters)` de du di sem tin.
• `(Antagonists)`: dεn ya de wok bay we dεn de mek sכm `(Nyurotransmitta dεm)` nכ de biεn to wan nεv. spεshal wan, if `(Nyurotransmitta)` de we de intafεr di `(Pεristalsis)` prכsεs, dεn `(Antagonist)` dεm de blכk dεm fכ biεn di nεv.

dεn ``Prokinetic Agents'' dεm ya dεn sheb dεm mכr to difrεn kεtכgכri dεm, dipכnt pan aw εvri dכg de wok:

• `(Kolinerjik Agonist dɛn)`: .dis dεm de wok lεk wan ``(Nyurotransmitta)`` we dεn kכl `(Acetylcholine)`. `(Acetylcholine)` de mek di mכsul dεm na di intestin dεm kכntrikshכn. Ɛgzampul dɛn: `(Baklɔfen)`, `(Bɛtanɛkɔl)`, `(Niɔstigmin)`, `(Piridostigmin)`.
• `(Motilin Agonists)` (Macrolide Antibiotics): Dɛn wan ya de wok lɛk di `(Nyurotransmitta)` we dɛn kɔl `(Motilin). `(Motilin)` de mek di kכntrikshכn dεm na di sכmכl intestin. Sɔm drɔgs na dis grup na rili `(Antibiotics)` we dɛn kin gi fɔ trit baktriyal infɛkshɔn. Ɛgzampul dɛn: `(Ɛritromaysin)`, `(Azitromaysin)`.
• Sεrotonin Agonist dεm: dεn ya de wok lεk di nyurotransmitta sεrotonin. Lɛk sɛrotonin, dɛn kin mek di intestinal kɔntrakshɔn ɛn ɛp di bɛlɛ fɔ ɛmti. Ɛgzampul dɛn: Sisaprid, Prukaloprayd, Tegaserod.
• `(Dopamine Antagonists)`: dεn ya de mek di `(Nyurotransmitta)` we dεn kכl `(Dopamine)` nכ de biεn di nεv sεl dεm. `(Dopamine)` de ridyus di muvmεnt fכ di bכdi εn di intestin dεm, εn i de rilaks di `(LES)` bak. so, we `(Dopamine)` stכp fכ biεn, dεn `(Dopamine Antagonists)` dεm de rivεs da ifekt de (i.e. inkrεs muvmεnt). Ɛgzampul dɛn: `(Mɛtɔklɔpramid)`, `(Dɔmpɛridɔn)`.

Sɔm ɛgzampul dɛn fɔ `(Prokinetic Agents)`

Naw sɔm kayn ``Prokinetic`` mɛrɛsin dɛn de we dɛn kin yuz fɔ trit, sɔm pan dɛn dɔn ban na kɔntri dɛn lɛk Amɛrika bikɔs ɔf di sayd ɛfɛkt, ɛn sɔm we stil de na di risach stej.

• Azithromycin (Zithromax®): Na wan agonist we de mek pɔsin gɛt motilin. Sɔntɛnde, dɔktɔ dɛn kin gi am ɔf-lɛbul fɔ gastroparesis.
• Baklɔfen (ED baclofen®): Na wan kɔlinɛrjik agonist. Dɛn stil de stɔdi bɔt di bɛnifit dɛn we i gɛt fɔ GERD.
• `(Bɛtanikɔl)` (Yurikolin®): Na wan `(Kɔlinɛrjik Agɔnis). I de ɛp wit `(Gastroparesis)` ɛn `(GERD)` simptom dɛm. Bɔt dɛn nɔ kin yuz am bɔku bɔku wan bikɔs i kin mek pɔsin gɛt siriɔs sayd ɛfɛkt lɛk we di mɔsul dɛn kin spam ɛn we pɔsin nɔ kin si fayn.
• Cisapride (Propulsid®): Na wan agonist we de mek pɔsin gɛt sɛrotonin. I de ɛp di bɛlɛ fɔ ɛmti kwik kwik wan. Bifo dis tɛm, dɛn bin de yuz am fɔ GERD. Dɛn pul am na di US makit bikɔs ɔf di sayd ɛfɛkt dɛn we gɛt fɔ du wit di at.
• `(Dɔmpɛridɔn)` (Motilium®): Wan `(Dɔpamin Antagɔnist). Insay Amɛrika, i nɔ kin izi fɔ gɛt am if dɛn nɔ gɛt spɛshal rayt fɔ gɛt am. I kin mek yu gɛt siriɔs at prɔblɛm lɛk aw yu at nɔ de bit ɔltɛm ɛn at atak.
• Erythromycin (EES®): Na wan Motilin Agonist. Dɔktɔ kin gi am ɔf-lɛbul fɔ gastroparesis.
• Metoklopramid (Reglan®, Maxeran®, Gimoti®): Na wan we de agens dopamin. Di onli FDA-apruv drɔg fɔ gastroparesis. Dɛn kin yuz am bak fɔ trit GERD we nɔ dɔn ansa to kɔmɔn tritmɛnt dɛn. Bɔt i kin kam wit wɔnin se i kin mek pɔsin gɛt sayd ɛfɛkt we kin afɛkt di nervɔs sistɛm.
• `(Prukaloprayd)` (Mɔtɛgriti®): .Wan `(Sɛrotonin Agɔnis)`. Dɛn kin gi am fɔ kɔnstipɛshɔn we nɔ de dɔn. I de ɛp bak fɔ mek di bɛlɛ ɛmti kwik kwik wan.
• Pyridostigmin (Mestinon®): Na wan kɔlinɛrjik agonist. Dɛn kin yuz am mɔ fɔ trit Myasthenia Gravis, bɔt sɔm tɛm dɛn kin yuz am bak fɔ trit Gastroparesis.

Wetin na di sayd ifekt dɛm we yu kin gɛt we yu yuz dɛn `(Prokinetic Agents)` ya?

Dis na di tin we impɔtant pas ɔl we wi fɔ tek tɛm wit. Prokinetic agents kin gɛt siriɔs sayd ɛfɛkt. Na dat mek bɔku tɛm dɔktɔ dɛn nɔ kin want fɔ gi dɛn mɛrɛsin. Bɔt we kɔmɔn tritmɛnt lɛk PPI fɔ GERD nɔ de wok, dɔktɔ kin disayd fɔ gi yu wan prokinɛtik ɛjɛn. Ɔ, fɔ tek tɛm, dɛn kin gi dɛn fɔ smɔl ɔ fɔ shɔt tɛm.

If dɔktɔ gi yu wan prokinetic agent, mek shɔ se yu aks bɔt di patikyula sayd ɛfɛkt dɛn we da mɛrɛsin de gɛt.

Di kɔmɔn sayd ɛfɛkt dɛn na:

• Bɛlɛ de at
• Nɔs ɛn vɔmit
• Dayarɛa (we pɔsin kin blo) .
• Di vishɔn we nɔ klia
• Ɛd we de at (ed we de at) .
• We pɔsin taya
• Drowsiness, taya pasmak, slip ɔltɛm (Lethargy) .
• Pwɛl at
• Wɔri
• Di mɔsul dɛn we nɔ de kɔntrol (Dystonia) .
• Di muvmɛnt dɛn we di fes mɔsul dɛn nɔ de kɔntrol (Tardive Dyskinesia) .

Dɛn bin pul drɔgs lɛk `(Cisapride)`, `(Domperidone)` ɛn `(Tegaserod)` na di makit bikɔs ɔf di risk fɔ gɛt siriɔs at prɔblɛm. Dat na:

• Slow at rit (Bradycardia) .
• At we nɔ de bit ɔltɛm (Aritmia) .
• At atak

di risach we dεn de du naw fכ nyu prokinetic ejen dεm de fכs fכ divεlכp dεn dεm we de gi di bεnεfit fכ stimulate intestinal kכntrikshכn dεm we de ridyus di risk fכ dεn kayn sayd ifekt dεm ya.

Wetin na di `(Prokinetic Agents)` we dɛn kin yuz mɔ?

di prokinetik ejen dεm we dεn kin gi mכst na Metoclopramide εn Domperidone. Insay Amɛrika, Metoclopramide na di wan ol mɛrɛsin we FDA dɔn gri fɔ fɔ mek pɔsin gɛt gastroparesis. Bɔt dɔktɔ kin gi yu Domperidone wit FDA aprɔval.

Prokinetic ejen dεm difrεn pan dεn effektiv εn sef fכ trit dijestiv dizכrd. Bikɔs i kin gɛt prɔblɛm wit di sayd ɛfɛkt dɛn, dɔktɔ kin tray ɔda mɛrɛsin bifo i gi am wan prokinɛtik ɛjɛn. Bɔt if yu gɛt siriɔs sik bikɔs yu bɔdi nɔ de kɔntrakt fayn, wan prokinɛtik ɛjɛn kin gi yu rilif we yu rili nid. If yu de tink bɔt fɔ tek wan prokinetic agent, i impɔtant fɔ tɔk bɔt di bɛnifit ɛn risk dɛn wit yu dɔktɔ.

Di tin dɛn we impɔtant pas ɔl fɔ mɛmba (Take-Home Message) .

So, a op se yu dɔn lan sɔntin frɔm wetin wi dɔn tɔk bɔt `(Prokinetic Agents)`. Fɔ sɔmtin:

• di prokinetik ejen dεm na wan kayn mεdikal we de mek di dijestiv trakt muv bכku εn i de εp fכ digεstiv prכsεs.
• Dɛn kin yuz dɛn tin ya fɔ sɔm kɔndishɔn dɛn lɛk `(Gastroparesis)` ɛn `(GERD)`, ɛn bak fɔ tin dɛn lɛk nɔs ɛn vɔmit.
• Dis mεdisin de wok bay we i de mek di nεv dεm na di intestinal dεm εn mek di mכsul dεm kכntrakt.
• Di tin we impɔtant pas ɔl na dat, sɔntɛnde dɛn mɛrɛsin ya kin gɛt siriɔs sayd ɛfɛkt. Na dat mek dɔktɔ go tek tɛm gi dɛn mɛrɛsin.
• Nɔ ɛva yuz dis kayn mɛrɛsin we yu nɔ go to dɔktɔ. Dɔktɔ fɔ disayd us mɛrɛsin fayn fɔ yu ɛn aw lɔng yu fɔ tek am.

If yu gɛt bɛlɛ we de at ɔ yu gɛt prɔblɛm wit yu digest lɛk dis, di bɛst tin fɔ du na fɔ go to dɔktɔ ɛn tɔk bɔt am. Dɔn yu kin gɛt di rayt tritmɛnt.

` prokinetik ejen dεm, bεlε we de at, indigεshכn, gastritis, GERD, gastroparesis, mεtoklopramid