Syed Muhammad Shamim, Syed Muhammad Masood Ali.
Metoclopramide A Drug with versatile therapeutic uses
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Mar 2002;7:256-62.
Pharmacology & Therapeutics Karachi Medical & Dental College, Karachi
Metoclopramide a benzamide acts centrally by blocking dopamine D2 receptors in the CTZ and peripherally by enhancing the action of acetylcholine at muscarinic nerve endings in the gut. It increases gastric peristalsis while relaxing the pylorus and first part of the duodenum. It has no action on gastric secretions. It is the prokinetic of choice. The drug is effective in diabetic gastroparesis. Metoclopramide is effective and polar drug for many types of vomiting, postoperative, drug induced, disease associated (especially migraine), radiation sickness, it is less effective in motion sickness. It is also effective in vomiting induced by highly emetic anticancer drugs. Female patients who undergo operative procedures develop nausea which can be controlled by metoclopramide. Postoperative nausea and vomiting can be controlled with the drug. It is also effective in drug induced nausea and vomiting. It is also effective in the treatment of migraine. It has also been advised for hyperemesis gravidarum. Regarding use of metoclopramide during pregnancy to determine its use further studies are required. Its adverse effects include extra pyramidal symptoms. Antimuscarinic drugs; benzteropine given I/v can abolish the reaction. Prolonged use in elderly may produce tardive dyskinesia. Metoclopramide induced pseudotetanus has been reported, methemoglobinemia and sulfhemoglobinemia have also been reported. It is effective in nausea and vomiting induced in various conditions, like postoperative, gynaecological procedures, cytotoxic drugs. It is also effective in migraine it is a good prokinetic agent.
Category: Pharmacology
Keywords: Dopamine Blockers. Metoclopramide. Vomiting.
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