#Drug #Neurology #Gastroenterology

Metoclopramide

evan April 12, 2024

Drug Class	Antiemetic (dopamine antagonist)
Mechanism	Blocks dopamine receptors in chemoreceptor trigger zone in the brainstem ↑ rate of gastric/duodenal emptying by relaxing pyloric sphincter
Typical Dose	10mg up to TDS
Indications	Hiccup, N&V in palliative care Acute migraine Post-cancer treatment/operative N&V
Contra-indications	Parkinsonism 3-4 days following GI surgery Intestinal obstruction
Side-effects	Common: asthenia, depression, diarrhoea, drowsiness, hypotension, Parkinsonism Rarely: confusion, arrhythmia, hallucination, hyperprolactinaemia
Interactions	Lithium: ↑ risk of extrapyramidal adverse effects NSAIDs: ↑ absorption of NSAIDs and their effects
Elimination
Additional Notes	Nausea/vomiting in migraine can cause gastric stasis - decreased absorption rate of paracetamol/aspirin. Metaclopramide to counter this