Clinical Medications Worksheets
Q ac & q hs
Normal dosage range
10-15 mg 30 min before meals and at bedtime (not to exceed 0.5mg/kg/day). A single dose of 20 mg may be given preventively.Some patients may respond to doses as small as 5 mg.
Why is your patient getting this medication
Management of esophageal reflux
For IV meds, compatibility with IV drips and/or solutions
Mechanism of action and indications(Why med ordered)
Metoclopramide inhibits gastric smooth muscle relaxation produced by dopamine, therefore increasing cholinergic responseof the gastrointestinal smooth muscle. It accelerates intestinaltransit and gastric emptying by preventing relaxation of gastric body and increasing the phasic activity of antrum. Simultaneously,this action is accompanied by relaxation of the upper smallintestine, resulting in an improved coordination between the bodyand antrum of the stomach and the upper small intestine.Metoclopramide also decreases reflux into the esophagus byincreasing the resting pressure of the lower esophageal sphincter and improves acid clearance from the esophagus by increasingamplitude of esophageal peristaltic contractions.Metoclopramide's dopamine antagonist action raises the thresholdof activity in the chemoreceptor trigger zone and decreases theinput from afferent visceral nerves. Studies have also shown thathigh doses of metoclopramide can antagonize 5-hydroxytryptamine (5-HT) receptors in the peripheral nervoussystem in animals.
Nursing Implications (what to focus on)
Hypersensitivity. Possible GI obstruction or hemorrhage. Historyof seizure disorders. Pheochromocytoma. Parkinson’s disease. Usecaution with history of depression. History of depression, diabetes,geriatric patients are more susceptible to over sedation andextrapyramidal reactions.
Common side effects
Drowsiness, extrapyramidal reactions, restlessness. NEUROLEPTIC MALIGNANT SYNDROME