GI Agents

Question 1

Which dopamine antagonist is the only FDA approved agent for treatment of diabetic gastroparesis?

Answer 1

metoclopramide is the only drug approved by the FDA for diabetic gastro paresis. Metoclopramide, via cholinergic stimulation, acts as a gastrointestinal prokinetic drug that increases lower esophageal sphincter tone and stimulates motility of the upper gastrointestinal tract.

Question 2

List seven common adverse effects of metoclopramide.

Answer 2

Adverse effects are 1) treatable hypotension and tachycardia (most common)

2) sedation
3) restlessness or nervousness 4) extrapyramidal symptoms 5) abdominal cramping following rapid intravenous injection
6) inhibition of plasma cholinesterase
7) galactorrhea

Question 3

State four contraindications to administration of metoclopramide

Answer 3

it’s an anti dopaminergic drug. Use with caution in patients with 1) Parkinson’s disease, 2) restless leg syndrome or who have 3) movement disorders related to dopamine inhibition or depletion. Metoclopramide is contraindicated in patients with intestinal obstruction due to metoclopramide’s prokinetic effects.