Let's talk about metoclopramide. Metoclopramide, brand name Reglan, is a commonly seen medication in nursing practice. You may hear this drug being part of several drug classes, but first and foremost, this drug is a dopamine receptor antagonist.
It's also known as a prokinetic. Pro meaning encourages and kinetic meaning movement. So this drug is known to encourage movement and motility in the GI tract.
And lastly, it's widely known as an anti-emetic. Anti meaning works against and emetic meaning related to vomiting. Let's look at the mechanism of action. Metoclopramide inhibits activity of dopamine and serotonin. Both dopamine and serotonin cause nausea and induce vomiting.
In turn, this calms activity in the chemoreceptor trigger zone, also called CTZ. This is the area of the brain that induces nausea and vomiting. With all this activity relieved, nausea and vomiting are prevented or treated.
Dopamine receptors in the GI are also known to relax the gut, slowing motility. It does this by working against these dopamine receptors. metoclopramide is able to speed up the process of motility and promote gastric emptying. You can remember this by the memory trick, metoclopramide, think motility. Let's look at what this drug is used for.
Metoclopramide counters nausea and vomiting, most commonly associated with cancer treatments. These are things like chemotherapy and radiation. Nausea and vomiting are also seen post-operatively in response to anesthesia or pain medications such as opioids.
This drug is often used for patients with gastroparesis or slowed gastric emptying. Remember, metoclopramide speeds up the process of gastric motility. This drug can be used to relieve heartburn, clinically known as gastroesophageal reflux disease or GERD. This medication improves gastric emptying, causing acid reflux, which also improves. As you can see, metoclopramide has a strong effect on the GI system, helping patients with different GI symptoms find relief.
Let's look at some contraindications. This drug should never be used for patients with a bowel obstruction. We do not want to increase motility if a blockage is present. This can worsen the blockage. Now, signs and symptoms of a bowel obstruction are nausea and vomiting.
So, verify there is no obstruction before administering this medication. Let's look at the must-know side effects of metoclopramide. A major side effect is something called tardive dyskinesia. Remember, metoclopramide impacts dopamine and serotonin receptors similarly to psychiatric medications.
Now, side effects of TD include erratic movement of the tongue, excessive blinking, lip smacking, jerking of extremities like hands and legs, and puffing of the cheeks. Symptoms of neuroleptic malignant syndrome can also occur from taking metoclopramide. Symptoms include muscle rigidity, tachycardia, and a high fever.
These are both emergencies and must be addressed immediately. Next, let's look at some nursing considerations. You want to monitor for signs and symptoms of tardive dyskinesia and neuroleptic malignant syndrome.
You also want to monitor their bowel sounds. Hyper and hypoactive can both indicate a bowel obstruction. Next is some patient education. You want to educate your patient to drink fluids as tolerated to aid with motility and prevents dehydration from the vomiting occurring.
You also want to avoid driving or operating heavy machinery because this medication can cause drowsiness and dizziness. Dry mouth can occur with metoclopramide, so we want to teach our patients to rinse their mouth frequently and suck on sugar-free candy to relieve symptoms of this dry mouth. Let's review some of the most commonly tested on regarding metoclopramide. This drug is a dopamine receptor antagonist used for nausea and vomiting, GERD, and faster gastric emptying. You want to be sure to monitor for signs of tardive dyskinesia and neuroleptic malignant syndrome.
We should never administer this medication to patients with a bowel obstruction. And we want to encourage patients to hydrate as tolerated to encourage proper GI function. If you want more information like this, you can find it in the Complete Pharmacology flashcards. It covers everything you need to know in your pharmacology class, but it's presented in a fun and condensed way. No more textbook fluff.
That's all for metoclopramide. If you found this video helpful, don't forget to subscribe to my YouTube channel. Happy studying, future nurses!