NA or other NANC 5HT 3 - ACh + - + 5HT 4 5HT 1or2 5-HT + + + ACh Enk +  ,, - - DA - D2 PERISTALTIC REFLEX Proximal Contraction Distal Relaxation WATER.

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Presentation transcript:

NA or other NANC 5HT 3 - ACh HT 4 5HT 1or2 5-HT ACh Enk +  ,, - - DA - D2 PERISTALTIC REFLEX Proximal Contraction Distal Relaxation WATER EXCRETION

NA or other ACh + - Water Excretion Motility ACh + X

+ Motility Don’t forget hormone actions esp. motilin, somatostatin

ACh + DA - D2

ACh + DA - D2 METOCLOPRAMIDE X

+ 5HT 4 ACh NANC 5HT 3 - ACh + 5-HT + + PERISTALTIC REFLEX Proximal Contraction Distal Relaxation

+ 5HT 4 ACh + CISAPRIDE TEGASEROD (5HT 4 agonists)

NANC 5HT 3 - ACh + 5-HT + ONDANSETRON ALOSETRON (5HT 3 antagonists) X INCREASED CONTRACTION BUT DECREASED MOTILITY!

ACh + Enk ,, - -

ACh + Enk NA or other - 5HT 1or2 5-HT + Enk +  ,, inhibition of 5-HT mediating segmentation (not shown)

NA or other ACh + - 5HT 1or2 5-HT +  ,, DIPHENOXYLATE LOPERAMIDE

NA or other NANC 5HT 3 - ACh HT 4 5HT 1or2 5-HT ACh Enk +  ,, - - DA - D2 METOCLOPRAMIDE is a DA antagonis that acts as cholinomimetics to increase motility DIPHENOXYLATE & LOPERAMIDE are opioids that decrease motility and reduce secretion CISAPRIDE and TEGASEROD are 5Ht4 agonist s that increase motility The “SETRONS”are 5Ht3 antagonist s that inhibit peristalsis ALVIMOPAN and METHYLNALTREXONE are opioid receptor antagonists that increase motility and increase secretion