Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: CAS:81098-60-4 (Cisapride)
 330 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind cross-over trial of oral cisapride 10 mg before meals and placebo was performed to determine its effects on colonic transit in patients with severe idiopathic constipation. Nine patients with less than 3 spontaneous bowel movements/wk were studied. After passing a tube to the cecum, 50 muCi of 111In-DTPA were instilled into the cecum and followed for 48 h using colonic transit scintigraphy. In the group as a whole, cisapride had little effect on transit. The patients were then divided into two groups based on transit: functional rectosigmoid obstruction (FRSO) and colonic inertia (CI). In the CI group, cisapride accelerated the half emptying time of the cecum and ascending colon from 2.50 to 1.21 h (p less than 0.05). The progression of the geometric center was also faster after cisapride in CI. In FRSO, the geometric center was unchanged by cisapride except at 48 h. Cisapride thus has a prokinetic effect on colonic transit in patients with severe idiopathic constipation, colonic inertia subtype. It may be a useful agent in the treatment of this group of patients.
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PMID:Cisapride accelerates colonic transit in constipated patients with colonic inertia. 230 47

We studied the effect of cisapride on oesophageal motor function and postprandial gastro-oesophageal reflux in a randomised, double blind, placebo controlled crossover study. In 16 patients with symptomatic gastro-oesophageal reflux, cisapride 10 mg orally and placebo were studied on separate days according to identical protocols. Cisapride and placebo were given 30 minutes before a standard meal. Each study day was preceded by corresponding three day oral loading of cisapride (10 mg tds) or placebo. Lower oesophageal sphincter pressure, oesophageal body motility and oesophageal pH were monitored for 30 minutes before and three hours after the meal. Plasma cisapride concentrations were measured before and after dosing on both study days. With cisapride treatment, the plasma cisapride levels ranged from 48.1 (5.0) to 75.9 (6.9) ng/ml. Plasma levels were undetectable during placebo treatment. Cisapride enhanced acid clearance but had no significant effect on the duration of acid exposure, the rate of reflux episodes, the pattern of lower oesophageal sphincter pressure associated with the reflux episodes, basal lower oesophageal sphincter pressure or oesophageal peristalsis. These findings do not suggest a major role for cisapride, at the dosage tested, for the control of troublesome postprandial gastro-oesophageal reflux.
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PMID:Effect of cisapride on postprandial gastro-oesophageal reflux. 268 Jul 94

Since gastro-oesophageal reflux disease is due to disturbances of oesophageal motility, motor and pH measurements are an important means to test a new anti-reflux drug, cisapride. In oesophageal manometry cisapride increased the pressure of the lower oesophageal sphincter in healthy volunteers and patients, and in the majority of studies it also strengthened the amplitude of oesophageal contractions. Cisapride lowered the total duration of acid exposure in the lower oesophagus in both volunteers and reflux patients. Thus cisapride may be useful in the treatment of gastro-oesophageal reflux disease.
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PMID:Cisapride in gastro-oesophageal reflux disease: effects on oesophageal motility and intra-oesophageal pH. 269 Mar 20

Cisapride is a new drug which stimulates gastrointestinal motility via facilitation of acetylcholine release from myenteric nerves. European studies have addressed its clinical efficacy in treating gastro-oesophageal reflux disease in three areas. 1) Symptom relief: Cisapride, usually at a dose of 10 mg t.i.d., was superior to placebo and metoclopramide in relief of daytime and night-time heartburn and regurgitation. 2) Healing oesophagitis: Six studies showed that cisapride 10 mg q.i.d effectively heals oesophagitis over 6-16 weeks. Cisapride was superior to placebo and as effective as H2-antagonists in healing grades I-III oesophagitis. Combination therapy with H2-antagonists may be superior to H2-blocker alone. 3) Paediatric efficacy: Cisapride 1 mg/kg/day was effective in the treatment of infants and children with oesophagitis and pulmonary symptoms related to acid reflux. In conclusion, cisapride offers a promising alternative for the treatment of gastrooesophageal reflux disease without the troubling side effects of existing promotility drugs.
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PMID:Efficacy of cisapride on symptoms and healing of gastro-oesophageal reflux disease: a review. 269 Mar 21

There have been several long term studies (greater than 4 weeks) of cisapride in a variety of gastroparetic conditions. All of these studies have used cisapride 10 mg t.i.d. or q.i.d. Chronic idiopathic dyspepsia Cisapride has been shown to be effective in both improving symptoms and also delayed gastric emptying in a six week study. In another placebo controlled study of two weeks, gastric emptying was improved but symptoms did not improve significantly. Diabetic gastroparesis In a four week study, cisapride has been shown to be effective in improving symptoms and solid phase gastric emptying. A six weeks study demonstrated both improvement of solid and liquid gastric emptying and symptoms. Progressive systemic sclerosis Cisapride was effective in improving symptoms over a four week period. Myotonic dystrophy Cisapride was effective in improving solid phase gastric emptying and symptoms over a four week period. Combined studies In two combined studies, cisapride has been shown to be effective in a variety of gastroparetic conditions. One year studies In three open long term studies, cisapride appears to be the first prokinetic agent to demonstrate long term efficacy for up to one year.
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PMID:Management of idiopathic, diabetic and miscellaneous gastroparesis with cisapride. 269 Mar 24

Cisapride has not been found to have a significant frequency of adverse reactions, except for diarrhoea which occurs in about 4% of individuals taking the drug. Cisapride is devoid of antidopaminergic effects (i.e. no neuro-endocrine effects such as prolactin increase; no extrapyramidal reactions). Clinical laboratory data show no effect of cisapride on haematology, blood chemistry, liver and kidney function. It is concluded that cisapride has a favourable safety profile.
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PMID:How safe and acceptable is cisapride? 269 Mar 26

A newborn presented with a picture of intestinal obstruction. Multiple biopsies of the small and large bowel showed an unusual neurogenic innervation. The myenteric plexus of Auerbach was severely depleted of ganglion cells and nerve fibers, while the submucous plexus of Meissner was normally innervated. An ileostomy failed to function and extended trial with experimental smooth muscle stimulant (Cisapride) was equally ineffective. The patient was finally treated by a myectomy from the duodenum to the descending colon with a sigmoid colostomy. This procedure, coupled with a Nissen fundoplication, stopped the vomiting and allowed normal defecation through the colostomy. The patient is presently taking increasing increments of oral fluids with a concomitant decrease in the volume of parenteral nutrition. The myectomy initiated marked hypertrophy of the muscularis mucosa. Could this muscular hypertrophy account for the improvement in bowel function? Possible etiology will be discussed. We caution that rectal submucosal suction biopsy alone may be misleading if normal ganglion cells and nerve fibers are found, yet the patient's clinical symptoms fail to improve. A full thickness bowel wall biopsy is then recommended.
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PMID:Deficient neurogenic innervation of the myenteric plexus with normal submucous plexus involving the entire small and large bowel. 272

Attempts have previously been made to reduce adhesion formation by promoting early intestinal motility. The prokinetic agent Cisapride was used in an animal model of end-to-end large bowel anastomoses. Twenty Wistar rats receiving Cisapride 1 mg/kg subcutaneously (sc) twice daily for two days post-operatively were compared with 20 controls receiving saline 0.2 mL in a similar regimen. The points of adhesion of the anastomosis to the following structures were enumerated: tubal fat; mesentery; omentum; caecum; small bowel; and abdominal wall. The treatment group had significantly fewer adhesions: 2.8 +/- 0.9 v 4.3 +/- 1.0. This was mainly in the number of small bowel attachments, 3.8% compared with 37.8%. The study was repeated using small bowel anastomoses. Cisapride again reduced the number of adhesions compared with controls: 2.1 +/- 0.4 v 4.2 +/- 1.4. Cisapride therapy resulted in greater post-operative stool weights and food consumption: control, 3.87 +/- 1.1 stool, 17.04 +/- 4.3 g food; Cisapride 4.43 +/- 0.9 g stool, 19.8 +/- 4.7 g food. The enhanced motility did not affect the anastomotic strength of the small bowel; bursting pressures at a constant inflation rate of 1.1 mL/min were: control 212.8 +/- 56.0 mmHg; Cisapride, 215.8 +/- 58.9 mmHg (NS).
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PMID:The prevention of post-operative adhesions using a gastrointestinal prokinetic agent. 273 17

The pharmacokinetic interaction between the gastrointestinal motility-stimulating substance cisapride and the H2-antagonist cimetidine was examined in 8 healthy volunteers (25 +/- 2 years of age). Steady-state kinetics of both substances were investigated after separate 1-week treatments of oral cisapride, 10 mg t.i.d., cimetidine, 400 mg t.i.d., and the two drugs combined. Cimetidine increased the cisapride peak plasma concentration from 58 +/- 25 ng/ml to 84 +/- 19 ng/ml (p = 0.01) and AUC0-24 from 509 +/- 289 ng/ml.h to 738 +/- 148 ng/ml.h (p = 0.02). Cisapride shortened the time to the peak concentration of cimetidine from 1.3 +/- 0.6 h to 0.6 +/- 0.2 h (p = 0.005) and reduced the cimetidine AUC0-24 from 11.0 +/- 2.3 micrograms/ml.h to 9.0 +/- 2.0 micrograms/ml.h (p = 0.05). It is concluded that cimetidine inhibits cisapride metabolism, whereas cisapride enhances the gastrointestinal absorption of cimetidine.
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PMID:Cisapride-cimetidine interaction: enhanced cisapride bioavailability and accelerated cimetidine absorption. 274 Nov 89

Paralytic ileus and intestinal adhesions are common events following intra-abdominal surgery. The theoretical hypothesis 'that stimulation of the postoperative bowel will reduce intestinal adhesions' was studied in a rat model for intestinal adhesions in which postoperative bowel motility was pharmacologically manipulated. Immediate postoperative stimulation of gastrointestinal motility by the prokinetic agent, Cisapride, resulted in a significant reduction in both the number and extent of adhesions. Inhibition of postoperative intestinal motility with the anticholinergic agent, atropine, resulted in a greater number of more dense adhesions involving an increased length of bowel.
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PMID:Pharmacological manipulation of postoperative intestinal adhesions. 278 96


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