Hospitals & Services

Gastro-Intestinal Drugs

Use of Gastro-intestinal Pro-Kinetic Agents

 

General

 
Gastric stasis, colonic and small intestinal ileus are common management problems in the intensive care unit.  It may be necessary to consider jejunal feeding tube placement and/or the use of prokinetic agents to facilitate enteral feeding (see algorithm on enteral feeding).

Commonly used GI Drugs

 

  1.  Anti-emetic

DrugDoseComments
Metoclopramide10 mg 6 hrly prn

Useful first line agent in mild-moderate nausea and vomiting

(May reduce gastric stasis, not first line)

Ondansetron4-8 mg IV 8hrly prn

Potent alternative anti-emetic

Expensive

Cyclizine25-50 mg IVI 8hrly prn

Useful second line anti-emetic

Histamine-1 receptor antagonist

Possible anticholinergic side effects, including tachycardia

 

  1. Pro-Motility Agents

Erythromycin250 mg IVI bd

Proven pro-kinetic agent

Limited by drug interactions (eg. fluconazole, aminophylline)

Metoclopramide10 mg 6 hrly prn

Useful first line agent in mild-moderate nausea and vomiting

May reduce gastric stasis (not first line)

Page last reviewed: 13 May 2014
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