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Pharmacology of Metoclopramide ; Mechanism of action, Pharmacokinetics, Uses, Effects
Metoclopramide is a medication used primarily as an antiemetic (to prevent nausea and vomiting) and as a prokinetic agent (to enhance gastrointestinal motility). Here are some key points about its pharmacology:
Mechanism of Action
Dopamine D2 Receptor Antagonist: Metoclopramide blocks dopamine receptors in the chemoreceptor trigger zone (CTZ) of the brain, which helps prevent nausea and vomiting.
Prokinetic Agent: It enhances the response to acetylcholine in the upper gastrointestinal tract, increasing gastric emptying and lower esophageal sphincter tone without stimulating gastric, biliary, or pancreatic secretions.
Indications
Nausea and Vomiting: Used to treat nausea and vomiting associated with chemotherapy, radiation therapy, and postoperative recovery.
Gastroesophageal Reflux Disease (GERD): Helps in treating GERD by increasing lower esophageal sphincter pressure.
Diabetic Gastroparesis: Used to treat delayed gastric emptying in diabetic patients.
Administration
Oral: Tablets, orally disintegrating tablets (ODT), and oral solution.
Intravenous (IV): Administered as an IV infusion.
Intramuscular (IM): Administered as an IM injection.
Dosage
Nausea and Vomiting: Typically 10 mg orally or 2 mg/kg IV/IM.
GERD: Dosage varies based on the severity of symptoms and patient response.
Side Effects
Common: Drowsiness, dizziness, and fatigue.
Serious: Extrapyramidal symptoms (e.g., acute dystonia, akathisia, parkinsonian features), tardive dyskinesia (with long-term use), and hyperprolactinemia.
Precautions
QT Prolongation: Monitor for prolonged QT interval, especially in patients with a history of heart conditions.
Renal and Hepatic Impairment: Dosage adjustments may be necessary for patients with severe renal or hepatic impairment
#Metoclopramide
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