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Metoclopramide

Metaclopramide


Presentation

  • A case of severe metoclopramide-induced akathisia in a breast cancer patient being treated with chemotherapy is presented, eventually culminating in hospital admission.[ncbi.nlm.nih.gov]
  • Eighty-one papers were found using the reported searches, of which three presented the best evidence to answer the clinical question.[ncbi.nlm.nih.gov]
  • The present article aimed to review the literature to reveal studies comparing metoclopramide to either placebo or active comparators.[ncbi.nlm.nih.gov]
  • Metoclopramide successfully relieved the presenting symptom(s) of 137/146 (90.8%) and 139/154 (90.2%) patients in the BIG and SIG groups, respectively.[ncbi.nlm.nih.gov]
  • We present this case to highlight this uncommon side effect of a commonly used medication in the NICU.[ncbi.nlm.nih.gov]
Intravenous Administration
  • While there are case reports of drug-induced tardive dyskinesia after intravenous administration of metoclopramide, this is to our knowledge the first report of tardive dyskinesia after short-term treatment with oral metoclopramide in an adolescent.[ncbi.nlm.nih.gov]
  • We report a case of raised intracranial pressure in a head-injured patient following the intravenous administration of metoclopramide. The patient required admission to an intensive care unit after a road traffic accident.[ncbi.nlm.nih.gov]
  • 2 minutes through a peripheral intravenous catheter Active Comparator: Promethazine Promethazine 10 mg intravenous administration Drug: Promethazine 12.5 mg intravenous dose administered over 2 minutes through a peripheral intravenous catheter Placebo[clinicaltrials.gov]
  • . - Cardiac conduction abnormalities have been reported after intravenous administration. Rare Side-effects - Methaemoglobinaemia.[nursingtimes.net]
  • Intravenous administration of Metoclopramide Injection, USP, diluted in a parenteral solution should be made slowly over a period of not less than 15 minutes.[dailymed.nlm.nih.gov]
Respiratory Distress
  • Cyanosis without respiratory distress should suggest this diagnosis.[ncbi.nlm.nih.gov]
  • Her hospital course was complicated by multi-organ injury, including acute respiratory distress syndrome requiring venous-venous extracorporeal membrane oxygenation, non-ST elevation myocardial infarction, cardiogenic shock, acute liver failure, and oliguric[ncbi.nlm.nih.gov]
  • Dysrhythmia, respiratory distress/arrest, neuroleptic malignant syndrome, and tardive dyskinesia were rarely associated with metoclopramide use.[ncbi.nlm.nih.gov]
Nausea
  • In adults, metoclopramide remains indicated for prevention of postoperative nausea and vomiting (PONV), radiotherapy-induced nausea and vomiting and delayed (but not acute) chemotherapy-induced nausea and vomiting, and for symptomatic treatment of nausea[ema.europa.eu]
  • CONCLUSION: Reductions in nausea severity for this adult ED nausea and vomiting population were similar for 4 mg intravenous ondansetron, 20 mg intravenous metoclopramide, and placebo.[ncbi.nlm.nih.gov]
  • According to our study, ginger is less effective than metoclopramide in reducing nausea and vomiting but it could be a good alternative for metoclopramide.[ncbi.nlm.nih.gov]
  • A total of 300 patients presented to the ED met the inclusion criteria: 151 (50.3%) with nausea/vomiting, 108 (36%) with headache, and 41 (13.7%) with headache and nausea/vomiting.[ncbi.nlm.nih.gov]
  • In adults, metoclopramide remains indicated for prevention of post-operative nausea and vomiting (PONV), radiotherapy-induced nausea and vomiting and delayed (but not acute) chemotherapy-induced nausea and vomiting, and for symptomatic treatment of nausea[ema.europa.eu]
Vomiting
  • In adults, metoclopramide remains indicated for prevention of postoperative nausea and vomiting (PONV), radiotherapy-induced nausea and vomiting and delayed (but not acute) chemotherapy-induced nausea and vomiting, and for symptomatic treatment of nausea[ema.europa.eu]
  • According to our study, ginger is less effective than metoclopramide in reducing nausea and vomiting but it could be a good alternative for metoclopramide.[ncbi.nlm.nih.gov]
  • A total of 300 patients presented to the ED met the inclusion criteria: 151 (50.3%) with nausea/vomiting, 108 (36%) with headache, and 41 (13.7%) with headache and nausea/vomiting.[ncbi.nlm.nih.gov]
  • Vomiting stopped after the injections, but she felt tired, confused and dizzy.[ncbi.nlm.nih.gov]
  • In adults, metoclopramide remains indicated for prevention of post-operative nausea and vomiting (PONV), radiotherapy-induced nausea and vomiting and delayed (but not acute) chemotherapy-induced nausea and vomiting, and for symptomatic treatment of nausea[ema.europa.eu]
Early Satiety
  • Symptoms include vomiting, nausea, early satiety, weight loss, epigastric pain especially after eating. The physical examination may not be helpful because the pyloric mass is difficult to palpate.[ncbi.nlm.nih.gov]
  • The primary end point was the change in total symptom score from baseline to week 4, based on symptom items (nausea, bloating, early satiety, and upper abdominal pain) reported in daily diaries.[ncbi.nlm.nih.gov]
Hypertrophic Pyloric Stenosis
  • Severe peptic ulcer resulting in hypertrophic pyloric stenosis is a rare clinical problem nowadays. Symptoms include vomiting, nausea, early satiety, weight loss, epigastric pain especially after eating.[ncbi.nlm.nih.gov]
Upper Abdominal Pain
  • The primary end point was the change in total symptom score from baseline to week 4, based on symptom items (nausea, bloating, early satiety, and upper abdominal pain) reported in daily diaries.[ncbi.nlm.nih.gov]
Dysgeusia
  • The most common treatment-emergent adverse effects were dysgeusia, headache, and fatigue. CONCLUSIONS: Metoclopramide nasal spray reduces symptoms of gastroparesis in women, but not in men, with diabetes.[ncbi.nlm.nih.gov]
Cyanosis
  • Methemoglobinemia is a condition characterized by increased level of methemoglobin in the erythrocytes and brownish cyanosis.[ncbi.nlm.nih.gov]
  • Cyanosis without respiratory distress should suggest this diagnosis.[ncbi.nlm.nih.gov]
Chest Pain
  • She developed acute hypertensive emergency (acute agitation, worsening headache, chest pain and wide complex tachycardia) when her blood pressure (BP) increased to 223/102mmHg (initial BP, 134/86mmHg) after receiving intravenous MCP.[ncbi.nlm.nih.gov]
  • One participant reported chest pain with sumatriptan 100 mg. In GL/MIG/001A/92 only one "major" adverse event was reported by more than 1% of participants: 4/348 reported chest pain with sumatriptan 100 mg.[doi.org]
Muscle Twitch
  • twitching 134.78 30.58 38 2355 3859 3379607 Economic problem 129.41 30.58 25 2368 472 3382994 Cardio-respiratory arrest 126.88 30.58 51 2342 15389 3368077 Agitation 124.63 30.58 54 2339 19652 3363814 Hypotension 120.54 30.58 71 2322 49443 3334023 Dyspnoea[drugcentral.org]
Altered Mental Status
  • NMS has a constellation of signs and symptoms, including hyperthermia, muscle rigidity, autonomic instability, tachycardia, tachypnea, diaphoresis, hypertension and altered mental status.[ncbi.nlm.nih.gov]
  • Vital signs were notable for hypotension, and physical examination revealed altered mental status with muscle rigidity. Laboratory testing revealed metabolic acidosis and increased prothrombin and partial thromboplastin times.[ncbi.nlm.nih.gov]
Encephalopathy
  • A 79-year-old man with long-term PD developed acute encephalopathy after the administration of i.v. metoclopramide.[ncbi.nlm.nih.gov]
  • A case of prolonged encephalopathy and worsened parkinsonism in a Parkinson disease patient exposed to a short course of metoclopramide is described. Parkinson disease (PD) is the second most common neurodegenerative disease in the United States.[ncbi.nlm.nih.gov]

Workup

  • Sepsis workup revealed no evidence of bacterial infection. He subsequently recovered fully and was discharged home with pediatric follow-up. This case represents the first description of NMS in association with metoclopramide in a healthy boy.[ncbi.nlm.nih.gov]

Treatment

  • […] and erythromycin treatment.[ncbi.nlm.nih.gov]
  • (after other treatments have been considered or tried) for the prevention of delayed nausea and vomiting after chemotherapy and for the treatment of post-operative nausea and vomiting.[ema.europa.eu]
  • METHODS: We randomly divided 70 patients who had been referred to an emergency department, into two equal treatment groups with the two treatment plans, and analyzed pain severity at baseline using a numeric rating scale (NRS).[ncbi.nlm.nih.gov]
  • BACKGROUND: Limited data exist regarding the efficacy of metoclopramide in the treatment of intractable hiccups. AIM: This study aimed to assess the feasibility efficacy of metoclopramide in the treatment of patients with intractable hiccups.[ncbi.nlm.nih.gov]
  • These symptoms are rarely reversible and there is no treatment. But in some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped.[webmd.com]

Prognosis

  • By indi where can i order generic metoclopramid will smoke and salt prognosis get into the heart.[rainbow.yogafest.info]

Etiology

  • The risks of weight gain that accompany the administration of metoclopramide are discussed, as well as the postulated etiology and psychological implications for the patient.[ncbi.nlm.nih.gov]
  • STW 5 is the only HMP for which efficacy has been shown in randomized controlled clinical trials (RCTs) in functional dyspepsia and irritable bowel syndrome, based on its multitarget effect on numerous etiological factors.[ncbi.nlm.nih.gov]
  • Arif Dalvi and Ashvini Premkumar, Tremor: Etiology, Phenomenology, and Clinical Features, Disease-a-Month, 57, 3, (109), (2011). Charlotte Buscombe, Sundus H. Alusi and David A.[doi.org]

Epidemiology

  • Manitoba and Saskatchewan administrative health care utilization databases are used differently to answer epidemiologic research questions. J Clin Epidemiol 2008 ;61: 192 - 197 26. Misset B, Nakache D, Vesin A, et al.[doi.org]
  • Friedman, Tardive dyskinesia: Epidemiology, Journal of the Neurological Sciences, (2018). Carey N. Pope and Stephen Brimijoin, Cholinesterases and the fine line between poison and remedy, Biochemical Pharmacology, (2018). G. Di Nardo, C.[doi.org]
  • Corresponding Author: Björn Pasternak, MD, PhD, Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark ( bjp@ssi.dk ).[doi.org]
  • Neither clinical studies nor epidemiologic studies conducted to date, however, have shown an association between chronic administration of these drugs and mammary tumorigenesis; the available evidence is too limited to be conclusive at this time.[dailymed.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • In view of the rarity of this syndrome and the overlap with the pathophysiologic manifestations of a burn, the burn surgeon may not readily recognize NMS on presentation.[ncbi.nlm.nih.gov]
  • The possible pathophysiologic mechanisms for the adverse reactions include a single-drug effect, a pharmacodynamic interaction, and a pharmacokinetic interaction. We believe that a pharmacodynamic interaction is most likely.[ncbi.nlm.nih.gov]
  • Review article: the pathophysiology of gastrooesophageal reflux disease - oesophageal manifestations. Aliment Pharmacol Ther. 20 , 14-25. Boeckxstaens, GE (2007). Review article: the pathophysiology of gastrooesophageal reflux disease.[jnmjournal.org]
  • Tenback, Tardive Dyskinesia: Clinical Presentation and Treatment, Pathophysiology, Pharmacology, and Biochemistry of Dyskinesia, 10.1016/B978-0-12-381328-2.00008-0, (187-210), (2011).[doi.org]

Prevention

  • Our findings suggest that metoclopramide 10 mg i.v. is effective to prevent PONV in patients having surgical procedures under general anaesthesia. Metoclopramide seems to be a reasonable agent to prevent PONV. [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]
  • CONCLUSIONS: Our study proved the functionality of metoclopramide in preventing ileus.[ncbi.nlm.nih.gov]
  • The aim of this study was to verify if A D is superior to metoclopramide plus dexamethasone (M D) in preventing delayed emesis in cancer patients receiving the same prophylaxis for acute emesis.[ncbi.nlm.nih.gov]
  • In adults, it may be used for the prevention and treatment of nausea and vomiting such as that associated with chemotherapy, radiotherapy, surgery and in the management of migraine.[ema.europa.eu]
  • Serotonin antagonists, such as ondansetron, have proved effective in the prevention of nausea and vomiting associated with cancer chemotherapy. Read More[britannica.com]

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