Prokinetica

Prokinetica is a term used in pharmacology to describe substances or interventions that stimulate gastrointestinal motility, promoting the movement of contents through the stomach and intestines. In clinical contexts it is commonly treated as a descriptor for prokinetic drugs, though usage of the term varies across texts and may appear as a brand-like name or shorthand.

Prokinetica encompass several mechanisms. Some agents act as antagonists of dopamine D2 receptors, which enhances gastric contractions and accelerates gastric emptying (examples include metoclopramide and domperidone). Others are 5-HT4 receptor agonists that increase acetylcholine release in the gut, thereby boosting propulsion (such as prucalopride and mosapride). Motilin receptor agonists, such as erythromycin, stimulate migrating motor complexes. A subset may act on smooth muscle or the enteric nervous system to speed up transit. The net effect is increased gastric emptying and improved intestinal propulsion.

They are used to treat conditions characterized by reduced GI motility, including gastroparesis, functional dyspepsia, and certain cases of chronic constipation or postoperative ileus. Choice depends on demonstrated efficacy, safety profile, patient comorbidities, and potential drug interactions.

Common side effects include nausea, diarrhea, dizziness, and, for dopamine antagonists, extrapyramidal symptoms. Some agents carry risks of QT prolongation or cardiovascular effects, which can limit use. Long-term benefit may be tempered by tachyphylaxis and adverse effects, necessitating ongoing monitoring and individualized therapy.

As a term, prokinetica is not universally standardized; clinicians generally refer to specific prokinetic drugs rather than a single class. Ongoing development aims to improve efficacy while reducing central and cardiovascular risks.