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Reglan (metoclopramide)

Reglan (metoclopramide)

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Published by: E on Oct 19, 2008
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07/02/2013

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Clinical Medications Worksheets
Generic Name
Metoclopramide 
Trade Name
Reglan 
Classification
Antiemetics
Dose
5 mg
Route
PO
Time/frequency
Q ac & q hs
Peak 
Unknown
Onset
30-60 min
Duration
1-2 hr 
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
N/A
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)
Contraindications/warnings/interactions
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
 
Interactions with other patient drugs, OTC or herbalmedicines (ask patient specifically)Keppra, gabapentin, Lamictal
: Central nervous system- and/or respiratory-depressant effects may be additively or synergisticallyincreased in patients taking multiple drugs that cause these effects,especially in elderly or debilitated patients.
Seroquel
: Coadministration of metoclopramide with phenothiazines or other neuroleptic agents may increase the risk of severe extrapyramidal reactions. The mechanism is additiveantidopaminergic effects. In addition, central nervous system-depressant effects may be additively or synergistically increasedin patients taking multiple drugs that cause these effects,especially in elderly or debilitated patients.
Lab value alterations caused by medicine
May alter hepatic function test results. May cause increased serum prolactin and aldosterone concentrations.
Be sure to teach the patient the following about this medication
Take as directed, may cause drowsiness, avoid driving. Do notdrink alcohol and other CNS depressants. Instruct patient to takemetoclopramide exactly as directed. If a dose is missed, take assoon as remembered if not almost time for next dose. Advise patient to avoid concurrent use of alcohol and other CNSdepressants while taking this medication.Advise  patient to notiy health cae  poess

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