Prokinetic Agents
Ac#on: Increase wave-like contrac1ons in the esophagus, increases contrac1ons in the stomach and promotes the emptying of
stomach contents by s1mula1ng excitatory neurotransmi=ers like acetylcholine and suppressing inhibitory neurotransmi=ers like
dopamine and serotonin.
Indica#on for Use: Chemotherapy-induced nausea and vomi1ng, GERD, Diabe1c gastroparesis, Gastrointes1nal dysmo1lity, chronic
cons1pa1on
Pre-assessment/Nursing Interven#ons: Get baseline vitals. Make sure pa1ent has no known allergies to medica1on. Assess bowel
sounds and frequency, quan1ty, and consistency of stools periodically during therapy. Get baseline assessment of mental health
status and signs or symptoms of depression, suicidal thoughts or behaviors. Check for any recent bowel surgeries as this medica1on
can cause stress to suture lines.
Post Administra#on/Nursing interven#ons: Reassess vital signs, assess for extrapyramidal symptoms and tardive dyskinesia. Assess
for GI distress such as cons1pa1on, nausea or vomi1ng. Monitory for side effects and adverse effects. Evaluate for occurrence/
frequency of complete spontaneous bowl movements.
Side Effects: Abdominal pain, diarrhea, nausea, abdominal dissension, flatulence, vomi1ng, headache, dizziness, fa1gue
Adverse/Toxic Effects: Suicidal thoughts/behavior, depression, increase in cardiac QT at high doses and has been associated with
causing Tosade de Pointes. Tardive dyskinesia, Parkinsonian features, May contribute to causing serotonergic syndrome when
combined with SSRIs.
Contraindica#ons: Hypersensi1vity, intes1nal perfora1on or obstruc1on, obstruc1ve ileus, Crohn’s disease, ulcera1ve coli1s, toxic
megacolon/megarectum, end stage renal disease/dialysis.
Pa#ent Educa#on:
• Take medica1on as prescribed. In oral administra1on, allow 30 minutes to 1 hour before ea1ng.
• Medica1on can cause drowsiness, be sure to avoid driving or other dangerous ac1vi1es un1l side effects are known.
• Fa=y and spicy foods should be avoided as well as alcohol.
• No1fy health care provider if depression worsens or suicidal thoughts/ac1ons develop.
Prokinetic Agents
References:
Kerr, M. (2020, April 13). Prokine(c agents. Healthline. Retrieved May 4, 2023, from h=ps://www.healthline.com/health/gerd/
prokine1cs#Types-of-Prokine1cs
Divya Jacob, P. D. (2021, June 18). Prokine(c agents: Drug class, uses, side effects, drug names. RxList. Retrieved May 4, 2023, from
h=ps://www.rxlist.com/how_do_prokine1c_agents_work/drug-class.htm