Case 4- Metaclopramide And Domperidone

Question 1

What is the mechanism of action of metoclopromide?

Answer 1

D2 receptor antagonist

Also antagonists @ 5HT3
- decreasing GI relaxation
- decrease emesis

Question 2

How long should you use metoclopromide to treat nausea and vomiting ?

Answer 2

5 days

Question 3

What are the side effects with metoclopromide ?

Answer 3

Sedation
Dizziness
Diarrhoea
Parkinsonism

Question 4

Why is it advices that metoclopramide is avoided in Parkinson’s disease

Answer 4

Can cross the BBB
Making symptoms of PD worse

Question 5

Name an alternative antiemetic used in Parkinson’s disease?

Answer 5

Domperidone

Question 6

What is the mechanism of action of domperiodone

Answer 6

D2 receptor antagonist

Question 7

Why is domeperidone more appropriate than metoclopramide ?

Answer 7

It does not cross the bbb only shows peripheral action therefore can be used in PD

Question 8

What counselling points would you give a patient taking domeperidone?

Answer 8

Do not take for more than a week
Can cause dry moth
Take before bed