Metoclopramide

Question 1

What drug class is Metoclopramide?

Answer 1

D2 receptor antagonist

Question 2

What are the common indications of Metoclopramide?

Answer 2

• GORD
• Ileus (paralytic ileus)
• An add-on for hyperemesis gravidarum
• for rescue in chemotherapy nausea

Question 3

What is the mechanism of action of Metoclopramide?

Answer 3

Acts on the visceral afferents in the gut

Increased ACh at muscarinic receptors in the gut and so promotes gastric emptying (increases tone of LOS, and tone and amplitude of gastric contractions and peristalsis and decreases the tone of the pylorus)

Question 4

What are the common adverse reactions of Metoclopramide?

Answer 4

• Galactorrhoea (due to prolactin release)
• Extra-pyramidal effects - dystonia and parkinsonism

(Don’t use if there’s a risk of perforation or obstruction)

Question 5

What are the common drug-drug interactions of Metoclopramide?

Answer 5

Can make extra-pyramidal effects (dystonia and parkinsonism) worse so caution with anti-psychotics

Will antagonise the effects of dopaminergic drugs (e.g. used to treat Parkinson’s)