Gastric electrical stimulation: An emerging therapy for children with intractable gastroparesis

Table 1 Synopsis of commonly used prokinetic agents for gastroparesis[7]

Prokinetic agents	Mechanism	Comments/Limitations
Erythromycin	Motilin receptor agonist	QT interval prolongation
Azithromycin		Tachyphylaxis
		Antibiotic and bacteria resistance
Metoclopromide	D2 antagonist (central/peripheral)	Extrapyramidal symptoms (e.g., tardive dyskinesia, dystonia). Can not use > 12 wk
	5-HT3 antagonist	QT interval prolongation
	5-HT4 agonist	FDA approved for adults
Domperidone	Peripheral D2 antagonist	QT interval prolongation
		Not approved in United States. Only available through IND
Baclofen	GABAB receptor agonist that inhibits transient lower esophageal sphincter relaxation. Increases gastric emptying	Muscle weakness, dizziness
		Very limited data, as trial was limited to a gastroesophageal reflux patients

FDA: Food and drug administration; D₂: Dopamine receptor 2; 5-HT₃ and 5-HT₄: 5-hydroxytryptomine receptor 3 and 4; GABA_B: Gamma-amino-butyric-acid B receptor; IND: Investigational new drug.