Erythromycin is sometimes used as a prokinetic agent in diabetic gastroparesis. The property responsible for this use is:

• A Enhancement of acetylcholine release via muscarinic M3 receptors
• B Antagonism of dopamine D2 receptors in the chemoreceptor trigger zone
• C Stimulation of motilin receptors in the gastrointestinal tract ✓
• D Inhibition of gastric 5-HT3 receptors

Explanation

Erythromycin is a motilin receptor agonist. At low doses it mimics motilin and triggers migrating motor complex-like activity, increasing gastric emptying, which is exploited in gastroparesis. Metoclopramide works by D2 antagonism and 5-HT4 agonism, cisapride acts on 5-HT4, and none of these involve motilin. The prokinetic effect is independent of erythromycin's antibacterial action and occurs at subtherapeutic antibiotic doses.

Reference: KD Tripathi Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.