Propulsid (Cisapride) Questions

Greetings — I attempted to post this once before, but got no response.  I’m
not sure if I managed to post it at all.  Apologies if this is the 2nd time
you’ve seen this.
_______________________

I was wondering if anyone has any experience with or in-depth knowledge of
a medication named Propulsid from Janssen.  My doctor has prescribed it
for my reflux and I have been using samples for a week or so and seem to
be feeling a lot better (I had been using Zantac for about 2 mo. then
Prilosec, another, more powerful acid inhibitor, for 2 mo., then Zantac
again for 1 mo.).  I was pretty queasy for the 1st day I started on
Propulsid, but that problem was gone by the 2nd day.  I’m still taking the
Zantac.  I’ve also modified my diet somewhat to reduce fried foods, REAL
spicy foods, Pop, late-night snacks, etc.

What does Propulsid do?  I can’t get a good explanation from my Dr.  Why
wouldn’t Propulsid be used initially rather than treating the symptoms
with acid inhibitors for so long?

Along the same lines, is there any internet source (Telnet, FTP, Gopher,
etc.) for the equivalent of the PDR to get info on medications and
interactions?

———————————————————————-
Al Schendlinger                   |Email: alan.r.schendlin…@cdev.com
Computing Devices International   |Phone: (612) 921-6307
8800 Queen Ave. South             |Fax: (612) 921-6869
Bloomington, MN  55431            |       "This Space For Rent"
———————————————————————-

5 Responses to “Propulsid (Cisapride) Questions”

  1. admin says:

    I tried posting this once but got no response, so I’m not sure If I actually
    posted at all.  Apologies if this is the 2nd time you’ve seen this.
    ++++++++++++++++++++

    Greetings…
    I was wondering if anyone has any experience with or in-depth knowledge of
    a medication named Propulsid from Janssen.  My doctor has prescribed it
    for my reflux and I have been using samples for a week or so and seem to
    be feeling a lot better (I had been using Zantac for about 2 mo. then
    Prilosec, another, more powerful acid inhibitor, for 2 mo., then Zantac
    again for 1 mo.).  I was pretty queasy for the 1st day I started on
    Propulsid, but that problem was gone by the 2nd day.  I’m still taking the
    Zantac.  I’ve also modified my diet somewhat to reduce fried foods, REAL
    spicy foods, Pop, late-night snacks, etc.

    What does Propulsid do?  I can’t get a good explanation from my Dr.  Why
    wouldn’t Propulsid be used initially rather than treating the symptoms
    with acid inhibitors for so long?

    Along the same lines, is there any internet source (Telnet, FTP, Gopher,
    etc.) for the equivalent of the PDR to get info on medications and
    interactions?

    ———————————————————————-
    Al Schendlinger                   |Email: alan.r.schendlin…@cdev.com
    Computing Devices International   |Phone: (612) 921-6307
    8800 Queen Ave. South             |Fax: (612) 921-6869
    Bloomington, MN  55431            |       "This Space For Rent"
    ———————————————————————-

  2. admin says:

    In article <CsHLKq….@caracara.cdev.com>, alan.r.schendlin…@cdev.com (Al

    Schendlinger) wrote:

    > I was wondering if anyone has any experience with or in-depth knowledge of
    > a medication named Propulsid from Janssen.  My doctor has prescribed it

    > What does Propulsid do?  I can’t get a good explanation from my Dr.  Why

    That’s a shame! Here’s some info I have from a Computer-based training
    program regarding GERD and its treatment:

    Treatment for the patient with Gastroesophageal reflux disease (GERD) must
    be individualized based upon the degree of symptoms, the severity of
    esophagitis, and the presence of complications (such as ulcer, stricture or
    Barrett’s esophagus).  Generally, however, physicians follow a stepwise
    approach.  

    Initial therapy for all patients generally involves lifestyle modifications
    aimed at reducing reflux.  Antacids are routinely used to provide
    symptomatic relief of heartburn.

    While these measures may be sufficient for patients with mild symptoms,
    those with moderate to severe symptoms of esophagitis or complications will
    require more intensive drug therapy.

    Several types of agents are now available to treat GERD.  These include H2
    antagonists and proton pump inhibitors (which reduce gastric acidity),
    prokinetic agents (which improve upper GI motility), and mucosal
    protectants (which enhance mucosal defenses against errosive refluxate).
    PROPULSID is a unique prokinetic agent, developed by Janssen, with a
    specific mechanism of action.

    PROPULSID may be classified as an indirect cholinergic agonist.  It
    selectively enhances the release of acetylcholine from cholinergic nerves
    in the myenteric plexus.  This action directly stimulates muscle cells in
    the gut wall.

    Drug therapy has historically started with an H2  antagonist for acid
    suppression, because metoclopramide, the only available prokinetic agent,
    produces a variety of undesirable side effects.  With the availability of
    safer, more specific prokinetic agents like PROPULSID, physicians will now
    be able to treat GERD by direct action on the physiologic defects that
    allow reflux to occur.  Because of their extreme potency, proton pump
    inhibitors are reserved for patients with severe esophagitis complicated by
    ulcer, stricture, or Barrett’s esophagus, or those who are unresponsive to
    conventional medications.

    > Along the same lines, is there any internet source (Telnet, FTP, Gopher,
    > etc.) for the equivalent of the PDR to get info on medications and
    > interactions?

    Keep an eye on MecklerWeb, a WWW site (under construction at:
    http://www.mecklerweb.com/demo.html), which will have an area devoted to
    medicine and a sub-domain specific to pharmaceutical information.

    Hope this helps.

  3. admin says:

    In article <CsHL5o….@caracara.cdev.com>,

    Al Schendlinger <alan.r.schendlin…@cdev.com> wrote:
    >Greetings…
    >I was wondering if anyone has any experience with or in-depth knowledge of
    >a medication named Propulsid from Janssen.  My doctor has prescribed it
    >for my reflux and I have been using samples for a week or so and seem to
    >be feeling a lot better (I had been using Zantac for about 2 mo. then
    >Prilosec, another, more powerful acid inhibitor, for 2 mo., then Zantac
    >again for 1 mo.).
    >What does Propulsid do?  I can’t get a good explanation from my Dr.  Why
    >wouldn’t Propulsid be used initially rather than treating the symptoms
    >with acid inhibitors for so long?

    Propulsid (cisapride), among other things, increases the tone of the
    esophageal sphincter, making it more likely to stay shut and avoid acid
    reflux up into the esophagus.  It also reduces the time food stays in
    the stomach (increases gastric emptying).

    Speaking generally, these drugs (others are Reglan [metoclopramide]
    and Motilium [domperidone]) don’t work quite as well alone to treat
    GERD as more traditional acid-suppressive drugs.  They’re useful as
    adjuncts.  Good that it works for you.


    Steve Dyer
    d…@ursa-major.spdcc.com

  4. admin says:

    In article <354sru$…@search01.news.aol.com>, BRAD RX <bra…@aol.com> wrote:
    >In article <CsJD9v….@spdcc.com>, d…@spdcc.com (Steve Dyer) writes:

    >     As a Pharmacist I am depressed to find out that people still are not
    >sure of what  they are taking and why.  You mentioned that your doctor
    >didn’t have much info for you, but how about your pharmacist.  I give out
    >a lot of info every day to people even if they didn’t get the drugs at my
    >pharmacy, I even offer reference books for people to read.  I would advise
    >talking to your pharmacist if they seem to busy try evenings or weekends
    >when business is slower.  If your Pharmacy doesn’t give this kind of
    >service find a new one !

    I think you screwed up the attribution here, since I wasn’t the person
    complaining about lacking drug info.  However, I think you have a wonderful
    attitude–all pharmacists should be so helpful and forthcoming!


    Steve Dyer
    d…@ursa-major.spdcc.com

  5. admin says:

    In article <2vcqst$…@search01.news.aol.com>,

    DRAGONS2B <dragon…@aol.com> wrote:
    >A friend of mine without access to the net is taking Phendimetrazine
    >for appetite suppression.  How does this differ from Phentermine
    >(Fastin)?  I have read that Fastin is a Class 4 controlled substance,
    >but this bottle of hers says that this drug is a Class 3.  Is this
    >more dangerous than Fastin? More effective?  She is taking a 35mg
    >pill 3x/day.  Does it work also as a metabolic stimulant (i.e. would
    >she burn calories faster on this with the same amount of calories per
    >day, as she would without the drug, but with the same amount of
    >calories???)  Thanks for your replies!  

    Ignore the chemical details here if you get snowed.

    Phenmetrazine is a cyclicized form of amphetamine, with the
    phenylisopropylamine moiety forming one side of a morpholine
    ring.  (Basically, ignoring the stereochemistry for the moment,
    take phenylpropanolamine and bridge the hydroxy and amino groups
    with an ethylene group.)  This is a secondary amine, with a single
    free hydrogen on the nitrogen atom.  Phenmetrazine is a C-II drug,
    in the same DEA schedule as amphetamine and methamphetamine.
    It was essentially a "me too" drug introduced in the 60′s by
    CIBA-Geigy to treat obesity, but it has about as much euphoriant
    and abuse potential as the prototype drugs.

    Phendimetrazine substitutes a methyl group on the nitrogen,
    so it’s a tertiary amine.  In the same way that N,N-dimethyl-
    amphetamine is a less potent stimulant than methamphetamine,
    so too is phendimetrazine less potent a stimulant than
    phenmetrazine.  As I mentioned last week, phentermine (Fastin)
    is also an amphetamine-like drug, but it has an extra methyl
    group on the alpha carbon, which also seems to cut the stimulant
    and euphoriant effects somewhat (though not entirely.)

    Is phendimetrazine more effective an anorectic drug than phentermine?
    Probably not.  They’re all more similar than different.  35mg 3x/day
    is a standard dose for phendimetrazine.  Is it more "dangerous"
    than phentermine?  The DEA scheduling choices are based on reports
    of abuse all over the world, so there’s probably some reason why
    phendimetrazine is C-III but phentermine is C-IV.  On the other hand,
    amphetamine abusers would probably enjoy access to either drug, and
    people who won’t have such problems probably wouldn’t discern a big
    difference between the two.

    Part of their effects in promoting weight loss may be due to metabolic
    stimulation, but the degree to which this contributes to the drugs’
    actions isn’t really very clear.


    Steve Dyer
    d…@ursa-major.spdcc.com

Leave a Reply

You must be logged in to post a comment.