Nutrition Flashcards
Metoclopramide (Reglan) Route
IV,PO
Metoclopramide (Reglan) Indications
GERD resistant to other treatments; Diabetic gastroparesis; promotility, chemo-induced nausea/vomiting
Metoclopramide (Reglan) MOA
Exact MOA unknown. Sensitizes tissues to Ach, stimulating upper GI tract motility; antagonizes central and peripheral dopamine receptors, producing antiemetic effects
Metoclopramide (Reglan) SE
Common:drowsiness,restlessness,fatigue,anxiety,insomnia,headache,confusion,dizziness, extrapyramidal sx, galactorrhea, amenorrhea, fluid retention, hypo/hypertension, nausea, diarrhea, urinary frequency/incontinence, rash, urticaria
Severe: dystonia, parkinsonism, tardive dyskinesia (US Boxed Warning), seizures, suicidality, hallucinations, acute CHF
Metoclopramide (Reglan) CI
pheochromocytoma,seizuredisorder,GIbleedingorobstruction
Metoclopramide (Reglan) Pearls
Used off-label for post-op nausea/vomiting that is unresponsive to other meds (ie. Zofran)
May result in an earlier tolerance to solid foods in patients exhibiting signs/sx of ileus
Can also be used for patients experiencing GERD and is safe for the pregnant patient
Use short term only (4-12 weeks), usually on inpatient basis. Increased duration of use is associated with tardive dyskinesia.
Erythromycin route
IV, PO
Erythromycin indications
a macrolide antibiotic that can be used off-label for gastroparesis/prokinetic agent. Generally used for persons who are intolerant of Reglan
Erythromycin MOA
Erythromycin evokes powerful, lumen-occluding antral contractions via action on neural and smooth muscle receptors for motilin, the physiologic regulator of fasting gastroduodenal motility
Erythromycin SE
Abdominal pain, N/V, rare QT prolongation and ventricular arrhymias, long-term use associated with superinfection (c.diff), caution in liver disease
Erythromycin CI
Hypersensitivity to macrolide drug class, pts with prolonged QT interval
Erythromycin Pearls
Can induce diarrhea
Does not alleviate N/V
Should be used for short-term only
“Banana Bag” indications
Alcohol use disorder (AUD)/ETOH withdrawal, magnesium deficiency in ICU patients
Thiamine Deficiency: Wernicke’s encephalopathy and Korsakoff syndrome
Folate Deficiency: Megaloblastic anemia, confusion, sleep disturbances, depression, and psychosis
Magnesium Deficiency: QT prolongation, torsades de pointes, altered mental status, seizures, tremors, hyperreflexia
“Banana Bag” MOA
Corrects vitamin and nutrient deficiencies through the following intravenous infusion: 1L NS or D5W, 100 mg Thiamine, 1 mg Folic Acid, 1-2 g Magnesium Sulfate, and 1 amp Multivitamin
“Banana Bag” SE
Anaphylaxis due to parenteral administration of nutrients