Antiemetics - Metoclopamide (Reglan)

Question 1

True or False: Metoclopramide (Reglan) is commonly used at ARMC.

Answer 1

False

Question 2

What is the typical dose range for Metoclopramide (Reglan) administered IV?

A) 5-10 mg every 6 hours

B) 10-20 mg every 6 hours

C) 20-30 mg every 6 hours

D) 30-40 mg every 6 hours

Answer 2

B) 10-20 mg every 6 hours

10-20 mg IV over 3-5 min Q6

Question 3

How should Metoclopramide (Reglan) be administered before induction?

A) 5 minutes prior to induction

B) 15-30 minutes prior to induction

C) 1 hour prior to induction

D) Immediately before induction

Answer 3

B) 15-30 minutes prior to induction

Question 4

Metoclopramide (Reglan) is usually administered in combination with which of the following medications?

A) Ondansetron

B) Pepcid

C) Lorazepam

D) Hydrocodone

Answer 4

B) Pepcid

Question 5

What is the concentration of Metoclopramide (Reglan) in its intravenous (IV) formulation?

A) 1 mg/mL

B) 2 mg/mL

C) 5 mg/mL

D) 10 mg/mL

Answer 5

C) 5 mg/mL

Question 6

What is the primary mechanism of action (MOA) of Metoclopramide (Reglan)?

A) Serotonin receptor antagonist

B) Dopamine receptor antagonist

C) Alpha-2 agonist

D) COX-2 inhibitor

Answer 6

B) Dopamine receptor antagonist

MOA: Dopamine receptor antagonist even in the CNS

Question 7

In addition to its central dopamine receptor antagonism, Metoclopramide (Reglan) has which of the following effects?

A) GI prokinetic effects

B) Vasoconstriction

C) Antihistaminic effects

D) Anticholinergic effects

Answer 7

Answer: A) GI prokinetic effects

Question 8

How does Metoclopramide (Reglan) produce its GI prokinetic effects?

A) By antagonizing dopamine receptors in the CNS

B) By stimulating selective cholinergic activity in the upper GI tract

C) By inhibiting serotonin receptors in the GI tract

D) By blocking COX-1 enzymes

Answer 8

Answer: B) By stimulating selective cholinergic activity in the upper GI tract

Question 9

How does Metoclopramide (Reglan) affect upper gastric motility?

A) It decreases lower esophageal sphincter tone.

B) It stimulates upper gastric motility.

C) It relaxes the pylorus and duodenum, thereby increasing transit time.

D) It inhibits upper gastric motility.

Answer 9

B) It stimulates upper gastric motility.

Question 9

Which of the following effects is caused by Metoclopramide (Reglan) in the gastrointestinal system? (Select all that apply)

A) Increased lower esophageal sphincter tone

B) Increased gastric motility

C) Relaxation of the pylorus and duodenum

D) Decreased gastric emptying time

Answer 9

A) Increased lower esophageal sphincter tone,
B) Increased gastric motility,
C) Relaxation of the pylorus and duodenum

*MOA: Dopamine receptor antagonist even in the CNS. GI Prokinetic and produces selective cholinergic stimulation of the upper GI tract. stimulates upper gastric motility→ increases lower esophageal sphincter tone & increases transit time by relaxing pylorus and duodenum *

Question 10

How does Metoclopramide (Reglan) exert its antiemetic and anti-nausea effects?

A) By antagonizing serotonin receptors in the chemoreceptor trigger zone

B) By antagonizing dopamine receptors in the chemoreceptor trigger zone

C) By stimulating histamine receptors in the vestibular system

D) By inhibiting acetylcholine receptors in the gastrointestinal tract

Answer 10

Answer: B) By antagonizing dopamine receptors in the chemoreceptor trigger zone

Question 11

What is the onset time of Metoclopramide (Reglan) when administered intravenously?

A) 1 minute

B) 3 minutes

C) 5 minutes

D) 10 minutes

Answer 11

Answer: B) 3 minutes

Question 14

What is the typical duration of action for Metoclopramide (Reglan)?

A) 30 minutes

B) 1-2 hours

C) 3-4 hours

D) 6-8 hours

Answer 14

B) 1-2 hours

Question 15

The elimination half-life of Metoclopramide (Reglan) is approximately:

A) 2 hours

B) 4 hours

C) 6 hours

D) 8 hours

Answer 15

C) 6 hours

Question 16

Which receptor does Metoclopramide (Reglan) primarily antagonize to exert its effects?

A) Dopamine-2 receptor

B) Serotonin receptor

C) Histamine receptor

D) Alpha-1 receptor

Answer 16

A) Dopamine-2 receptor (prokinetic)

Question 17

Metoclopramide (Reglan) should be avoided in patients with which of the following conditions? (Select all that apply)

A) Parkinsonism

B) Seizure disorder

C) Mild gastrointestinal discomfort

D) Gastrointestinal obstruction

Answer 17

A) Parkinsonism,
B) Seizure disorder,
D) Gastrointestinal obstruction

Question 17

Which of the following conditions is a contraindication for the use of Metoclopramide (Reglan)?

A) Extrapyramidal symptoms

B) Mild nausea

C) Allergic reactions

D) Gastroesophageal reflux disease (GERD)

Answer 17

A) Extrapyramidal symptoms

Question 19

Select all that apply: Metoclopramide (Reglan) is contraindicated in patients with:

A) Extrapyramidal symptoms

B) Parkinsonism

C) Severe allergic reactions

D) Seizure disorders

Answer 19

A) Extrapyramidal symptoms
B) Parkinsonism
D) Seizure disorders

and GI obstruction

Question 20

When prescribing Metoclopramide (Reglan) to elderly patients, which of the following is a key precaution?

A) Increased risk of developing hypertension

B) Potential for increased agitation

C) Decreased risk of extrapyramidal symptoms

D) Higher tolerance to side effects

Answer 20

B) Potential for increased agitation

Question 21

. Which of the following are common central nervous system (CNS) side effects of Metoclopramide (Reglan)?

A) Restlessness

B) Drowsiness

C) Insomnia

D) Bradycardia

E) Agitation

Answer 21

A) Restlessness,
B) Drowsiness,
C) Insomnia
E) Agitation

Question 22

Which of the following extrapyramidal symptoms can occur as a side effect of Metoclopramide (Reglan)? (Select all that apply)

A) Dystonia

B) Spasms

C) Restless motor function

D) Parkinsonism

Answer 22

All of the above

Question 23

True or False: Metoclopramide (Reglan) may cause abdominal cramps, especially when administered rapidly intravenously.

Answer 23

Answer: True

Question 24

True or False: Hypotension and HR changes are a known cardiac side effect of Metoclopramide (Reglan).

Answer 24

True