Tack J, Coremans G, Janssens J
Department of Internal Medicine, University Hospital Gasthuisberg, University of Leuven, Belgium.
Drug Saf. 1995 Jun;12(6):384-92. doi: 10.2165/00002018-199512060-00004.
Cisapride is a substituted benzamide compound that stimulates motor activity in all segments of the gastrointestinal tract by enhancing the release of acetylcholine from the enteric nervous system. Cisapride is administered orally in the treatment of gastro-oesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction syndromes and chronic constipation. In gastro-oesophageal reflux disease in both adults and children, cisapride provides symptomatic improvement and mucosal healing. Long term treatment with cisapride is effective in the prevention of relapse of oesophagitis. Cisapride improves gastric emptying rates and improves symptoms in patients with gastroparesis of various origins. Unlike domperidone and metoclopramide, long term administration of cisapride seems to result in persistently enhanced gastric emptying. Cisapride is also effective in improving symptoms in patients with functional dyspepsia. In comparative studies in patients with functional dyspepsia, cisapride was at least as effective as metoclopramide, domperidone, clebopride, ranitidine and cimetidine. Cisapride increases stool frequency and reduces laxative consumption in patients with idiopathic constipation. Severe cases of slow transit constipation seem refractory to cisapride. Clinical studies also indicate that cisapride might be effective in the treatment of chronic intestinal pseudo-obstruction, postoperative ileus, peptic ulcer and irritable bowel syndrome. Further clinical studies are warranted to define the role of cisapride in these conditions. The dosage of cisapride ranges from 5mg 3 times daily to 20mg twice daily. Cisapride is generally well tolerated, both during short and long term treatment. In children, cisapride is also well tolerated in doses of 0.2 to 0.3 mg/kg, 3 to 4 times daily.(ABSTRACT TRUNCATED AT 250 WORDS)
西沙必利是一种取代苯甲酰胺化合物，它通过增强肠神经系统中乙酰胆碱的释放来刺激胃肠道各段的运动活性。西沙必利口服用于治疗胃食管反流病、功能性消化不良、胃轻瘫、慢性肠道假性梗阻综合征和慢性便秘。在成人和儿童的胃食管反流病中，西沙必利可改善症状并促进黏膜愈合。西沙必利长期治疗对预防食管炎复发有效。西沙必利可提高胃排空率，并改善各种原因引起的胃轻瘫患者的症状。与多潘立酮和甲氧氯普胺不同，长期服用西沙必利似乎能持续增强胃排空。西沙必利对改善功能性消化不良患者的症状也有效。在功能性消化不良患者的对比研究中，西沙必利至少与甲氧氯普胺、多潘立酮、氯波必利、雷尼替丁和西咪替丁一样有效。西沙必利可增加特发性便秘患者的排便次数并减少泻药用量。严重的慢传输型便秘病例似乎对西沙必利难治。临床研究还表明，西沙必利可能对治疗慢性肠道假性梗阻、术后肠梗阻、消化性溃疡和肠易激综合征有效。有必要进行进一步的临床研究来确定西沙必利在这些病症中的作用。西沙必利的剂量范围为每日3次，每次5毫克至每日2次，每次20毫克。西沙必利在短期和长期治疗中一般耐受性良好。在儿童中，西沙必利每日3至4次，剂量为0.2至0.3毫克/千克时，耐受性也良好。（摘要截选至250字）
