Rationale for the development of a novel gastrointestinal prokinetic, cisapride

Several promotility drugs have been used to correct disorders caused by disturbed gastrointestinal motility. However these drugs have various drawbacks. Their effects on smooth muscle activity may be restricted to part of the digestive system, or may not be very efficient. On the other hand, their use is somewhat limited by side effects: drugs may not be specific for the motor functions of the gastrointestinal tract or not even for the gastrointestinal tract itself. The desirability of improving the promotility effects and eliminating the secondary effects of existing drugs constituted the rationale for developing cisapride. This aim was achieved by influencing--in a physiological way--the release of acetylcholine, the main neurotransmitter in the 'gut brain', the myenteric plexus.