Table 2. Medications that Affect Gastric Emptying Delayed gastric emptying
• Opioid analgesics • Anticholinergics • Tricyclic antidepressants • Calcium channel blockers • Progesterone • Octreotide • Proton pump inhibitors • H2
• Interferon alfa • L-dopa • Fiber
-receptor antagonists Accelerate gastric emptying
• Prokinetic agents ▶ Metoclopramide ▶ Macrolide antibiotics (eg, erythromycin)
▶ Domperidone ▶ Tegaserod
Categories Diabetic Gastroparesis
ÎBetween 20% and 40% of patients with diabetes mellitus develop dysfunction of the autonomic nervous system.
ÎTypically, symptoms occur after diabetes has been present for 5-10 years and patients have evidence of autonomic dysfunction.
ÎGastroparesis can contribute to worsening glycemic control due to erratic and slow gastric emptying.
ÎAcute hyperglycemia may cause delayed gastric emptying in both healthy individuals and individuals with diabetes, even when the autonomic nervous system is intact.
ÎMetabolic abnormalities such as hyperglycemia and electrolyte imbalances contribute to the acute disruption of GI motility in patients with diabetes. Clinically, this is most apparent when diabetic ketoacidosis occurs and the typical features of anorexia, nausea, vomiting, or abdominal pain develop. As the acute metabolic derangements are controlled, GI symptoms often improve.
• β-adrenergic receptor antagonists
• Sucralfate • Aluminum hydroxide antacids • β-adrenergic receptor agonists • Glucagon • Calcitonin • Dexfenfluramine • Diphenhydramine • Alcohol • Tobacco/nicotine • Tetrahydrocannabinol
