VOL: 101, ISSUE: 12, PAGE NO: 37
Generic and proprietary names
- Metoclopramide: Maxolon; Maxolon High Dose; Maxolon SR; Gastrobid Continus.
- Central dopamine receptor agonist.
- Enhances response to acetylcholine of tissue in the upper gastrointestinal tract, which results in contraction of gastric muscle.
- Relaxes pyloric duodenal segments.
- Increases peristalsis without stimulating secretions.
- Blocks dopamine in chemoreceptor trigger zone of central nervous system.
- Nausea and vomiting, particulary in gastrointestinal disorders and during treatment with cytotoxics or radiotherapy.
- Gastrointestinal obstruction, perforation or haemorrhage.
- Three to four days post gastrointestinal surgery.
- Hepatic and renal impairment.
- Older people.
- Young adults and children (the dose must be measured accurately with a pipette).
- Symptoms can mask underlying disorders such as cerebral irritation.
- Extrapyramidal effects (especially in children and young adults).
- Tardive dyskinesia can occur with prolonged treatment.
- Neuroleptic malignant syndrome.
- Cardiac conduction abnormalities have been reported after intravenous administration.
- Enhances effect of some analgesics.
- Antipsychotics: increased risk of extrapyramidal symptoms.
- Increased sedation in alcohol and other central nervous system depressants.
- Antimuscarinics: antagonism of effect on gastrointestinal activity.
- Oral, intravenous or intramuscular.
- Assess for extrapyramidal symptoms and tardive dyskinesia (more likely in older patients).
- Assess for gastrointestinal complaints, such as nausea, vomiting and constipation.
- In oral administration, for better absorption allow 30 minutes to one hour before eating.
- Rinse mouth frequently to combat dryness.
- Metoclopramide can cause drowsiness. Patient should avoid hazardous activities until stabilised.
- Store in a closed container in a cool place out of the reach of children.
- If there is nausea, fatty and spicy foods should be avoided.
- Avoid alcohol or other central nervous system depressants.
- If a dose is missed, the patient should take it as soon as possible. If the next dose is due within the next three hours, she or he should take a single dose immediately and skip the next one.
- The drug can be safely stopped as soon as a patient no longer needs it.
- An occasional unintentional extra dose is unlikely to cause harm.
- A large overdose could cause drowsiness and muscle spasms. A doctor should be notified.
Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines