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Itomash

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by

Hani ElShennawi

on 12 October 2015

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Transcript of Itomash

Poor adherence to medication regimen causes:-

Worsening of disease.

Increase healthcare costs.
ITOMASH
Is better and safer prokinetic agent.
ITOMASH
Is better and safer prokinetic agent.

Itomash is superior to other motility products
The net effect is an increase in ACh concentration, which in turn:
Promotes gastric motility.
Increases the lower esophageal sphincter pressure
Accelerates gastric emptying.
Improves gastro-duodenal coordination.

This dual mode of action of Itopride is unique and different from the actions of other prokinetic agents available in the market.
Cisapride “Prepulsed”
5-HT4 agonist and increases acetylcholine release in the enteric nervous system.
It has been withdrawn.
long QT syndrome, which predisposes to arrhythmias “5-HT4 in the heart”

Tegaserod “Zelmac”
5HT4 agonist.
FDA restricted.
Prokinetic + Antiemetic.
Prokinetic effect ↓over time unlike antiemetic effect
D2 & 5HT3↓, ↑5HT4
CNS SE up to 40%
Has extra pyramidal S/Es.
Metoclopramide
ITOMASH
Is better and safer prokinetic agent.
Comparative Evaluate of the efficacy & Tolerability of Itopride Hydrochloride & Domperidone in patients with Non-Ulcer Dyspepsia.
JAPI August 2004, Vol 52; 626-628.


JAPI:JOURNAL OF ASSOCIATION OF PHYSICIANS OF INIDA
ITOMASH Vs. Domperidone
ITOMASH in Heart Burn & Upper abdominal Pain
(Itopride 50 mg) is the 1st prokinetics That Treats Dyspepsia by treating the underlying causes with treat & stick to treat approaches:

Treat (GI Motility Normalizer)
Stick to treat ( Pill Keeper )
5HT4 agonist & 5HT3 antagonist.
Facilitating acetylcholine release from the enteric cholinergic neurones through a selective 5-HT4 serotonin receptor agonistic action.

Its main metabolite acts as an antagonist of the 5-HT3rec.s.

Mosapride has no anti-dopaminergic properties.
Short half-life of only 1-2 h (disadvantage)
Little information is available on its overall efficacy and safety(disadvantage).
MOSAPRIDE
Prokinetic, antiemetic.
D2 antagonist, doesn’t cross BBB.
Anti-dopaminergic side effect.
Increased prolactin. “Milk hormone”.
Not FDA approved.
Domperidone
Metoclopramide
Domperidone
Cisapride
Mosapride
Itopride
Prokinetic Drugs
In 2007, MASH has been awarded the

ISO - 9001 Certificate
For establishing, Implementing, and maintaining quality assurance systems in Design, Development, Production, Installation, and Servicing.

In 2007, MASH has been awarded the

ISO - 14001 Certificate
Regarding Environmental - Friendly practices.
Awards & Honors
MASH has been established in 1986.
MASH is considered one of the largest national producers of pharmaceuticals in Egypt.
MASH exports their pharmaceutical products to Arab Countries, and to some African, Asian and Gulf Areas.
Beside our well established position in the dermatological field, R&D department succeeded in enriching Mash’s productivity with 60 more launching products along the coming 5 years, these products will fill a diversified pharmaceutical categories, Gastroenterology & Neuropsychiatry are examples to be mentioned.
History
Thank you
Stomach:

Epigastric pain
Fullness
Bloating/belching
Early satiety
Esophagus:

Regurgitation
Retrosternal pain
Dysphagia
Heartburn
Symptoms related to upper GIT
Itomash
Itopride has dual mode of actions:-
- D2-Receptor antagonist
- Acetycholinesterase (AChE) inhibitor
Both effects result in increase of acetylcholine level Effects occur at similar concentration & are additive
Weak effect on prolactin level ( peripheral D2 )
No effect on serotonin receptors ( 5HT3 , 5HT4 )
Mechanisms of Action
26.7%
76.7%
63.3%
93.3%
Stomachache
Heartburn
Upset stomach
Fullness
Epigastric discomfort
Vomiting
Nausea
Early satiety
Bloating
Indigestion
22%
8%
5%
14%
70%
81%
12
Itopride
Effect on QT Interval of ECG in Anesthetized Rats
Each data shows the maximum change in QT interval after drug treatment and represents mean ±S.E. of 6 rats. **P<0.01 vs vehicle.
Change in QT interval
(mg/kg-hr, I.v.)
(in 5% lactic acid)
(%)
75
50
25
0
*
*
*
*
10
3
0
Cisapride
(in Saline)
100
30
0
Itopride
Indications
Itomash
Itomash in Vomiting & GERD
Poor adherence to medication regimen causes:-

Worsening of disease.

Increase healthcare costs.
Full transcript