Gastroparesis Medications – Test Prep and Practice Pearls

Gastroparesis can be a frustrating condition for both patients and clinicians, with symptoms such as nausea, vomiting, early satiety, bloating, and poor glycemic control significantly affecting quality of life. Medication management often requires balancing effectiveness with safety, especially since many commonly prescribed drugs can either improve or worsen gastric emptying. In this episode of the Real Life Pharmacology podcast, we’ll review the medications used to treat gastroparesis, discuss their mechanisms of action, highlight important adverse effects, and identify medications that may contribute to or exacerbate delayed gastric emptying.

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Erythromycin Pharmacology

Erythromycin uniquely has some potential benefit in the setting of gastroparesis. Azithromycin you will likely not see used for this indication.

Erythromycin binds the 50s subunit and ultimately prevents protein synthesis which is necessary for bacteria to grow and replicate.

QTc prolongation is a risk with all macrolide antibiotics (erythromycin included).

By inhibiting CYP3A4, erythromycin can be responsible for numerous drug interactions.

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