14120395
| Question | Answer |
| Trade names | Maxalon, Metamide, Metoclopramide Injection, Pramin |
| Pharmaceutical calss | Dopamine antagonist |
| Indications | N + V assoc with chemo, surgery, labour etc Treatment of GORD Increases gastric emptying |
| Action | Stimulates motility of upper GI tract and increases lower oesophageal sphincter tone and blocks dopamine receptors at chemoreceptor trigger zone. Decreases reflux into the oesophagus by increasing the resting pressure of the lower esophageal sphincter and improves acid clearance from the esophagus by increasing amplitude of esophageal peristaltic contractions Accelerates intestinal transit and gastric emptying by preventing relaxation of gastric body and increasing the phasic activity of antrum |
| Absorption & distribution | ABSORPTION:GIT DISTRIBUTION: Distributed to most body tissues and fluids, including the brain. Drug crosses the placental barrier and is distributed in breast milk. |
| Metabolism & excretion | METABOLISM + EXCRETION: Not metabolized extensively; a small amount is metabolized in the liver via conjugation. Excreted in urine and faeces. |
| half-life | 5 - 6 hrs |
| Contraindications/precautions | Contraindicated in individuals hypersensitive to drug, in those where GI motility poses risks (eg. those with haemorrhage, obstruction or perforation) Parkinson’s disease—avoid if possible as symptoms may worsen due to being a dopamine antagonist. Depression—avoid long-term use as mental state may worsen Contraindicated in those with phaeochromocytoma or seizure disorders |
| Adverse reactions | CNS: restlessness, drowsiness, dizziness, headache, fatigue, fever CV: transient hypertension, hypotension GI: nausea, diarrhoea, bowel disroders GU: urinary frequency, incontinence Skin: rash, urticaria |
| Interactions | Anticholinergics, opioid analgesics -antagonised GI motility effects of metoclopramide. Use cautiously together CNS depressants - avoid use together due to additive CNS effects Digoxin - dec. absorbtion of digoxin from stomach. Monitor. Paracetamol, levodopa, tetracyline - accelerated absorption of drugs from small bowel. Monitor. |
| Assessments | Blood pressure Alertness - nausea |
| Education | Advise person to avoid activities requiring alertness or 2 hours after each dose. Instruct person to report serious adverse reactions Use short term only (maximum of 5 days); risk of tardive dyskinesia increases with cumulative dose and length of treatment |
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