Metoclopramide (Reglan)

Overview

• Classifications: Dopamine receptor antagonist, prokinetic, anti-emetic
• Functions:
  • Encourages GI tract movement and motility
  • Prevents or treats nausea and vomiting

Mechanism of Action

• Inhibits dopamine and serotonin activity
  • Reduces activity in the chemoreceptor trigger zone (CTZ)
  • Calms nausea and vomiting triggers
• Works against dopamine receptors in the GI tract to speed up motility and promote gastric emptying

Uses

• Counteracts nausea and vomiting from:
  • Cancer treatments (chemotherapy, radiation)
  • Post-operative conditions (anesthesia, opioid use)
• Treats gastroparesis (slowed gastric emptying)
• Relieves heartburn (GERD)
  • Improves gastric emptying and reduces acid reflux

Contraindications

• Never use in patients with bowel obstruction
  • Increases motility can worsen blockages
• Verify no obstruction before administration

Side Effects

• Tardive Dyskinesia (TD): Erratic tongue movement, excessive blinking, lip smacking, jerking of extremities, puffing cheeks
• Neuroleptic Malignant Syndrome: Muscle rigidity, tachycardia, high fever
  • Both are emergency conditions requiring immediate attention

Nursing Considerations

• Monitor for:
  • Signs of tardive dyskinesia and neuroleptic malignant syndrome
  • Bowel sounds for potential obstructions (BOTH hyperactive and hypoactive)

Patient Education

• Drink fluids to support motility and prevent dehydration (for the vomiting)
• Avoid driving or operating heavy machinery (drowsiness/dizziness risk)
• Manage dry mouth with frequent rinsing and sugar-free candy

Key Points

• Dopamine receptor antagonist for nausea, vomiting, GERD, and faster gastric emptying
• Monitor for severe side effects like tardive dyskinesia and neuroleptic malignant syndrome
• Do not administer to patients with bowel obstruction
• Encourage hydration to support GI function

Additional Resources

• Complete Pharmacology flashcards offer condensed, essential information for pharmacology classes.