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Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency


Metoclopramide Reglan Antiemetics 5 mg PO Q ac & q hs
Peak Onset Duration Normal dosage range
Unknown 30-60 min 1-2 hr 10-15 mg 30 min before meals and at bedtime (not to exceed 0.5
mg/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 For IV meds, compatibility with IV drips and/or solutions
Management of esophageal reflux N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Metoclopramide inhibits gastric smooth muscle relaxation Hypersensitivity. Possible GI obstruction or hemorrhage. History
produced by dopamine, therefore increasing cholinergic response of seizure disorders. Pheochromocytoma. Parkinson’s disease. Use
of the gastrointestinal smooth muscle. It accelerates intestinal caution with history of depression. History of depression, diabetes,
transit and gastric emptying by preventing relaxation of gastric geriatric patients are more susceptible to over sedation and
body and increasing the phasic activity of antrum. Simultaneously, extrapyramidal reactions.
this action is accompanied by relaxation of the upper small Common side effects
intestine, resulting in an improved coordination between the body Drowsiness, extrapyramidal reactions, restlessness.
and antrum of the stomach and the upper small intestine. NEUROLEPTIC MALIGNANT SYNDROME
Metoclopramide also decreases reflux into the esophagus by
increasing the resting pressure of the lower esophageal sphincter
and improves acid clearance from the esophagus by increasing
amplitude of esophageal peristaltic contractions.
Metoclopramide's dopamine antagonist action raises the threshold
of activity in the chemoreceptor trigger zone and decreases the
input from afferent visceral nerves. Studies have also shown that
high doses of metoclopramide can antagonize 5-
hydroxytryptamine (5-HT) receptors in the peripheral nervous
system in animals.
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) May alter hepatic function test results. May cause increased serum
Keppra, gabapentin, Lamictal: Central nervous system- and/or prolactin and aldosterone concentrations.
respiratory-depressant effects may be additively or synergistically Be sure to teach the patient the following about this medication
increased in patients taking multiple drugs that cause these effects, Take as directed, may cause drowsiness, avoid driving. Do not
especially in elderly or debilitated patients. drink alcohol and other CNS depressants. Instruct patient to take
Seroquel: Coadministration of metoclopramide with metoclopramide exactly as directed. If a dose is missed, take as
phenothiazines or other neuroleptic agents may increase the risk soon as remembered if not almost time for next dose. Advise
of severe extrapyramidal reactions. The mechanism is additive patient to avoid concurrent use of alcohol and other CNS
antidopaminergic effects. In addition, central nervous system- depressants while taking this medication.
depressant effects may be additively or synergistically increased
in patients taking multiple drugs that cause these effects, A
especially in elderly or debilitated patients. d
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Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
Assess for nausea, vomiting, abdominal distention, Extrapyramidal side effects, hypersensitivity, Decreased symptoms of
and bowel sounds. Assess patient for extrapyramidal adverse side effects. esophageal reflux.
side effects. Monitor for tardive dyskinesia.
Monitor for neuroleptic malignant syndrome. Assess
patient for signs of depression periodically
throughout therapy.