Metoclopramide Flashcards
What are the indications for administering
metoclopramide?
It is administered to stimulate gastric emptying. It functions as
an antiemetic, as a treatment for gastroparesis, and can assist
in the placement of feeding tubes.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
248.
What local anesthetic is metoclopramide structurally
similar to?
Metoclopramide is structurally similar to the ester local
anesthetic procaine and the benzamide antiarrhythmic
procainamide.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
248.
On which receptor does metoclopramide act?
Metoclopramide antagonizes the dopamine D2 receptor
Katzung BG, Masters, SB, & Trevor AJ. Basic and Clinical
Pharmacology. 12th ed. New York: McGraw-Hill; 2012: 1092.
To what degree is metoclopramide protein-bound?
about 30%
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
247.
Does metoclopramide cross the blood-brain barrier?
Does it cross the placenta?
Yes, metoclopramide crosses the blood-brain barrier and the
placenta easily
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
247.
In addition to dopamine, what other receptor can
metoclopramide antagonize?
In high doses, metoclopramide can also block serotonin
receptors in the chemoreceptor trigger zone
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
247.
Where in the body does metoclopramide block
dopamine receptors?
In the chemoreceptor trigger zone
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
247.
What drugs increase the likelihood of extrapyramidal
symptoms in a patient taking metoclopramide?
When administered concurrently with metoclopramide,
phenothiazine derivatives such as thioridazine and
chlorpromazine and butyrophenones (droperidol) increase the
likelihood that the patient will experience extrapyramidal
symptoms.
Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail’s
Clinical Anesthesiology. 5th ed. New York, NY: McGraw-Hill;
2013: 282.
What are the most common side effects of
metoclopramide?
Metoclopramide can produce CNS side effects such as
restlessness, drowsiness, and agitation (in 10-20% of the
population). 25% of patients who are administered
metoclopramide in high doses or over a long period of time will
develop extrapyramidal symptoms such as dystonias, akathisias
and tardive dyskinesia.
Katzung BG, Masters, SB, & Trevor AJ. Basic and Clinical
Pharmacology. 12th ed. New York: McGraw-Hill; 2012: 1092.
Is metoclopramide contraindicated in obstetric
patients?
Although it crosses the placenta easily, it is not contraindicated
in obstetric patients undergoing surgery.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
247.
How does metoclopramide affect the muscle tissue
of the stomach?
It increases the tension of the lower esophageal sphincter and
fundus, while relaxing the pylorus and duodenum.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
248.
How is intravenous metoclopramide metabolized?
Orally-administered metoclopramide?
If administered intravenously, about 70% of metoclopramide is
conjugated in the liver. If administered orally, about 75% is
quickly eliminated by hepatic first-pass metabolism.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
247.
In what patients is metoclopramide contraindicated?
Metoclopramide is contraindicated in patients with Parkinson’s
disease, extrapyramidal symptoms, seizures, bowel obstruction,
and those who have had gastric surgery.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
248.
How does metoclopramide affect the action of
succinylcholine?
Metoclopramide inhibits plasma cholinesterase and prolongs
the duration of succinylcholine.
Ouellette RG and Joyce JA. Pharmacology for Nurse
Anesthesiology. Sudbury, MA: Jones & Bartlett Learning; 2011:
248
