Reglan (Metoclopramide)

Question 1

Drug Classification

Answer 1

Antiemetic

Question 2

Mechanism of Action

Answer 2

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

Question 3

Pharmacokinetics

Answer 3

• Onset of Action- 1-3 minutes IV, 10-15 minutes IM
• Peak Effects- 1-2 hours
• Duration of Effects- 1-3 hours
• Half-Life- 2.5-6 hours

Question 4

Indications/Field Use

Answer 4

Nausea/Vomiting

Question 5

Contraindications

Answer 5

• Possible GI Hemmorhage, bowel obstruction or perforation
• Seizure Disorder
• Pheochromocytoma
• Hypersensitivity

Question 6

Side Effects/Adverse Reactions

Answer 6

Dizziness, Drowsiness, fatigue, sedation, CNS depression, HTN/hypotension, bradycardia/tachycardia, diarrhea

Question 7

Dose

Answer 7

Adult:
10mg slow IV/IO over 1-2 minutes,

    10-20mg IM

Pedi:
Not for pedi

Question 8

Precautions

Answer 8

• May cause dystonia

- concurrent use of phenothiazines increases chance for dystonia

Question 9

Drug-Drug Interactions

Answer 9

• Opposed by a anticholinergics such as atropine

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