metochlopramide
Mechanism of Actiom:
Metoclopramide works by inhibiting the action of dopamine, a neurotransmitter that is involved in the regulation of gastrointestinal motility. By blocking the action of dopamine, metoclopramide increases the contractions of the muscles in the wall of the small intestine and stomach, which helps to speed up the movement of food through the gastrointestinal tract. This can help to reduce symptoms of nausea and vomiting and improve digestion.
Metoclopramide is also thought to have a prokinetic effect on the lower esophageal sphincter, which helps to prevent acid reflux from occurring.
Pharmacokinetics:
Metoclopramide is available in oral, intravenous, and intramuscular formulations. When taken orally, it is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 1-2 hours. The drug is metabolized in the liver and is excreted in the urine. Its half-life is approximately 6-8 hours.
Indications:
Metoclopramide is indicated for the treatment of symptoms of gastrointestinal disorders, such as nausea, vomiting, and GERD. It may also be used to treat certain symptoms of Parkinson's disease, such as difficulty swallowing.
Dosage:
The usual recommended adult dose of metoclopramide is 10-20 mg orally three to four times daily. The maximum daily dose is 40 mg per day. The intravenous and intramuscular formulations should be administered under the supervision of a healthcare professional.
Contraindications:
Metoclopramide should not be used in individuals with a known hypersensitivity to the drug or any of its components. It should also not be used in individuals with pheochromocytoma (a type of tumor that produces hormones) or in individuals with uncontrolled hypertension.
Warnings and precautions:
Metoclopramide may cause drowsiness and should be used with caution in individuals who are operating heavy machinery or driving. It should also be used with caution in individuals with a history of epilepsy or other seizure disorders, as it may increase the risk of seizures.
Metoclopramide may also cause a condition called tardive dyskinesia, which is characterized by involuntary, repetitive movements of the face, lips, tongue, and extremities. This condition may be irreversible and may occur after long-term use or even after the drug has been stopped.
Metoclopramide should be used with caution in individuals with liver or kidney disease, as the metabolism and excretion of the drug may be affected in these individuals.
Drug interactions:
Metoclopramide may interact with a number of medications, including but not limited to:
- CNS depressants (e.g. benzodiazepines, opioids)
- Antipsychotics
- Antidepressants
- Antiemetics (e.g. promethazine, prochlorperazine)
- Antihypertensives (e.g. beta blockers)
It is important to inform your healthcare provider about all medications that you are taking, including prescription and over-the-counter medications, as well as herbal supplements.
Adverse effects:
The most common adverse effects associated with metoclopramide include drowsiness, dizziness, and restlessness
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