Motilin Agonists

Erythromycin is a useful adjunctive therapy that can be added to metoclopramide or domperidone if nausea and vomiting persist despite maximal tolerated doses of these agents. It attaches to the motilin receptor and stimulates enteric contractility. It is not an antiemetic and concomitant agents to address nausea must also be initiated with this agent. Both intravenous and oral forms have been shown to improve gastric emptying rates, but this therapy can be complicated by cramping and abdominal pain. Low doses in a liquid (syrup) form are best to treat gas-troparesis (eg, 125 mg 2 or 3 times daily). A potential concern with this agent is that it loses effectiveness over time due to down regulation of the motilin receptor.

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Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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