Metoclopramide

Question 1

MoA

Answer 1

Antagonises D2 receptors in chemoreceptor trigger zone.
Acts directly on gut to promote gastric emptying; prokinetic effect

Question 2

MHRA warning

Answer 2

Risk of neurological adverse effects - restrict dose and duration of use

Question 3

Metoclopramide - restrictions for use

Answer 3

18+
5 days
10 mg TDS (max 500 mcg/kg)

Question 4

Indications

Answer 4

Prevention of N+V
- Post op
- Radiotherapy
- Delayed chemo induced

Symptomatic treatment of N + V
- Acute migraine
- Improve absorption of oral analgesics

Question 5

Side effects

Answer 5

Acute dystonic reactions
- Facial + skeletal muscle spasms
- More common in young and very old people (especially females)
- Procyclidine (anti-parkinsonian drugs) abo

Question 6

What drug is used to abort dystonic effects?

Answer 6

Procyclidine
- Anti-parkinsonian drug

Question 7

Interactions

Answer 7

Antipsychotics
- Increases extrapyramidal SE
Parkinson disease
- Exacerbates condition