Metoclopramide
HCL
Trade names: Pramin
Class: Anti-emetics Pregnancy:
(Category B) Action:
It is dopamine receptor antagonist
acts both centrally & peripherally, centrally due to the effect in the
CTZ ( inhibition) , Peripherally it stimulate the motility of the upper GIT
without affecting gastric & biliary or pancreatic secretions. It relaxes
the pyloric sphincter & increases the peristalsis of the duodenum resulting
in accelerated gastric emptying &
intestinal transit
Uses:
• Digestive disorders leading to relief GIT pain , Dyspepsia &
regurgitation in peptic ulcer, reflux esophagitis & postanasthetic
vomiting.
• Nausea & vomiting as in chemotherapy.
• Facilitate diagnostic procedure e.g. barium meal.
Dose:
by mouth, or by intramuscular injection or
by intravenous injection over 1–2 minutes, 10 mg (5 mg in young adults 15–19
years under 60 kg) 3 times daily; CHILD up to 1 year (up to
10 kg) 1 mg twice daily, 1–3 years (10–14 kg) 1 mg 2–3 times
daily, 3–5 years (15–19 kg)
2 mg 2–3 times daily, 5–9 years (20–29 kg) 2 mg 3 times
daily, 9–14 years (30 kg and over)
5 mg 3 times daily
Note. Daily dose of metoclopramide should
not normally exceed 500 micrograms/kg, particularly for children and young
adults.
Contraindications:
ü
Seizure (epilepsy) ,
ü Pheochromocytoma , & ü Intestinal
obstruction.
Side effects:
ü
GI disturbances,
ü
transient hypertension,
ü
supraventricular
tachycardia,
ü
dizziness
&
ü extrapyramidal effect “convulsion”.Nursing considerations:
§ Don’t give pramin to patients with epilepsy, pheochromocytomes
or patients with intestinal obstruction.
§ Administer oral medication 30 minutes before meal & at bed
time .
§ Administer I.V. injection slowly over 1-2 minutes.
Be aware of the extrapyramidal
symptoms specially in children
