Metoclopramide (Reglan)

Question 1

Metoclopramide Classification

Answer 1

Antiemetic

Question 2

Metoclopramide Mechanism

Answer 2

D2 (dopamine) R antagonist -> inhibits communication from the chemoreceptor trigger zone (which recognizes emetic toxins) to the vomiting center of the brain; inhibits gastric SMC relaxation, leading to increased motility of stomach contents into the small intestine

Question 3

Metoclopramide Pharmacokinetics

Answer 3

Onset: 1-3m IV, 10-15m IM
Peak: 1-2h
Duration: 1-3h
Half Life 2.5-6h

Question 4

Metoclopramide Indications

Answer 4

Nausea/Vomiting

Question 5

Metoclopramide Contraindications

Answer 5

• Possible GI hemorrhage, bowel obstruction, or perforation
• Seizure disorder
• Pheochromocytoma
• Hypersensitivity

Question 6

Metoclopramide Side Effects/Adverse Reactions

Answer 6

Drowsiness, fatigue, sedation, dizziness, CNS depression, HTN, hypotension, tachycardia, bradycardia, diarrhea

Question 7

Metoclopramide Dose

Answer 7

Adult:
10 mg slow IV IO over 1-2m, 10-20mg IM
Pedi:
Not for Pedi

Question 8

Metoclopramide Precautions

Answer 8

May cause dystonia; concurrent use of phenothiazines increases chances for dystonia

Question 9

Metoclopramide Drug Interactions

Answer 9

• Opposed by anticholinergics such as atropine

- Additive effects with CNS depressants such as narcotics, sedatives/hypnotics, EtOH