DRUG STUDY

Brand Name: Reglan, Maxolon, Gimoti, Metozolv ODT

Generic Name: Metoclopramide

Classification: Dopamine, Serotonin receptor antagonist

Action: Blocks dopamine/serotonin receptors in chemoreceptor trigger zone of the

CNS. Enhances acetylcholine response in upper GI tract, causing incresed motility

and accelerated gastric emptying without stimulating gastric, biliary, or pancreatic

secretions; increases lower esophageal sphincter tone.

Indication: Metoclopramide is used to treat the symptoms of slowed stomach

emptying in people who are recovering from certain types of surgery

Route/ Dosage/ Interval: 1 ampule IVTT

Half Life: 4 - 6 hours

Absorption: Gatrointestinal Tract

Drug Interaction: May increase adverse effects of antipsychotic (e.g., haloperidol),

promethazine, strong CYP2D6 inhibitors (e.g., fluoxetine, paroxetine) may increase

concentration/effect. May decrease therapeutic effect of anti-parkinson agents (e.g.,

pramipexole, ropinirole), cabergoline. May increase hypertensive effect of MAOIs

(e.g., phenelzine, selegiline). Rivastigmine may increase adverse/ toxic effect.

Excretion:through the kidneys

Adverse Effect: Extrapyramidal reaction occur most frequently in children, young

adults receiving large doses during chemotherapy and usually are limited to akathisia

(involuntary limb movement, facial grimacing, motor restlessness). Neuroleptic

malignant syndrome (diaphoresis, fever, unstable B/P, muscular rigidity) has been

reported.

Precaution/Contraindication: hypersensitivity to metoclopramide. Concurrent use of

medications likely to produce extrapyramidal reaction. Situations in which GI motility

may be dangerous (e.g., GI hemorrhage, GI perforation/obstruction), history of

seizure disorder, pheochromocytoma.

Nursing Responsibilities:

1. Baseline Assessment: Assess for nausea and vomiting, abdominal distention, bowel

sounds. Antiemetic: assess for dehydration (poor skin turgor, dry mucous membranes,

longitudal furrows in tongue).

2. Intervention/Evaluation: Monitor renal function, B/P, heart rate. Monitor for

anxiety, restlessness, extrapyramidal symptoms during IV administration. Monitor

daily pattern of bowel activity, stool consistency. Assess skin for rash. Evaluate for

therapeutic response from gastroparesis (nausea, vomiting, bloating).

3. Patient/Family Teaching: Avoid tasks that requires alertness, motor skills until

response to drug is established. Report involuntary eye, facial, limb movement. Avoid

alcohol.