Metoclopramide intestine

GASTROINTESTINAL STIM ULANTS. The nurse carefully times the administration of oral metoclopramide for 30 minutes before each meal. Dexpanthenol is administered intramuscularly or IV. The nurse tells the patient that intestinal colic may occur within 30 minutes of administration and that this is not abnormal and will pass within a short time... 

As first choice treatment a well-established antihistamine such as meclozine is recommended. Promethazine is another antihistamine which reduces nausea, but sedation is a not always desired adverse effect. Metoclopramide increases intestinal motility and could be used short term also early in pregnancy. A neuroleptic such as prochlorperazine reduces nausea but should only be used for shortterm treatment due to the risk of extrapyramidal adverse reactions. Serotonin receptor antagonists can be used in post-operahve nausea and during treatment with cytostatics. 

Some drugs giving less EPS were discovered serendipitously, such as metoclopramide, first used to treat gastro-intestinal disorders, led to the development of a series of related drugs for psychosis such as sulpiride, sultopride, and amisulpride. 

Metoclopramide is frequently used in combination with antacid therapy. It increases the tone of the lower oesophageal sphincter, increases stomach emptying, and because of this may speed absorption of drugs absorbed from the small intestine. 

Metoclopramide is structurally related to orthoclopramide, a procaine derivative, and it can prolong the action of suxamethonium because of competition for cholinesterase. However, its common side effects are similar to those seen with phenothiazine derivatives. In high doses, a range of extrapyramidal symptoms may develop. The anti-emetic effects of metoclopramide are due to two main actions. Centrally, it blocks dopamine in the CTZ and peripherally, it hastens gastric emptying, abolishes irregular intestinal contractions, and increases... 

Greater skill is required to place the feeding tube beyond the pylorus. Prokinetic agents, such as metoclopramide or erythromycin, facilitate passage of the tube into the small intestine. 

METOCLOPRAMIDE NS AIDS 1. Metodopramide speeds up the onset of action of tolfenamic acid 2. Metodopramide 1 efficacy of ketoprofen Metodopramide promotes gastric emptying 1. Tolfenamic acid reaches its main site of absorption in the small intestine more rapidly 2. Ketoprofen has low solubility and has less time to dissolve in the stomach therefore less ketoprofen is absorbed 1. This interaction can be used beneficially to hasten the onset of analgesia 2. Take ketoprofen at least 2 hours before metodopramide... 

Severe parkinsonism has been reported in a 73-year-old woman with tuberculosis of the large intestine who had taken metoclopramide for nausea she recovered on withdrawal of the drug and treatment with biperiden (7). 

There are conflicting data on the use of metoclopramide in horses. In some models of POI, metoclopramide appeared effective (Gerring Himt 1986), while others found that metoclopramide did not positively affect intestinal motility (Sojka et al 1988). Metoclopramide crosses the blood-brain barrier, where its antagonist properties on central dopamine D2 receptors can result in extrapyramidal signs, including violent excitation. 

Dart A J, Peauroi J R, Hodgson D R et al 1996 Efficacy of metoclopramide for treatment of ileus in horses following small intestinal surgery 70 cases (1989-1992). Australian Veterinary Journal 74 280-284 Daurio C R Holste J E, Andrews F M et al 1999 Effect of omeprazole paste on gastric acid secretion in horses. Equine Veterinary Journal Supplement 29 59-62 de Boer R E, Brouwer F, Zaagsma J 1993 The beta... 

Altered intestinal motility produces diarrhea by three mechanisms reduction of contact time in the small intestine, premature emptying of the colon, and bacterial overgrowth. Chyme must be exposed to intestinal epithelium for a sufficient time period to enable normal absorption and secretion processes to occur. If this contact time decreases, diarrhea results. Intestinal resection or bypass surgery and drugs (such as metoclopramide) cause this type of diarrhea. On the other hand, an increased time of exposure allows fecal bacteria overgrowth. A characteristic small intestine diarrheal pattern is rapid, small, coupling bursts of waves. These waves are inefficient, do not allow absorption, and rapidly dump chyme into the colon. Once in the colon, chyme exceeds the colonic capability to absorb water. 

Metoclopramide Stimulates gastric emptying and small intestine transit... 

Metoclopramide - stimulates gastric emptying and small intestine transit in barium imaging antiemetic Miconazole - antifungal... 

Metoclopramide is an antidopaminergic/GI stimulant that stimulates upper GI tract motility, resulting in accelerated gastric emptying and intestinal transit and increased resting tone of lower esophageal sphincter. It exerts antiemetic... 

Metoclopramide increases gastric transit time, enhancing the absorption of substances absorbed in the small intestine (e.g., ethanol, cyclosporin) and decreasing the absorption of substances absorbed in the stomach (e.g., cimetidine, digoxin). Anticholinergic drugs and dopamine-function-enhancing substances such as levodopa reduce the effectiveness of metoclopramide. Because metoclopramide releases catecholamine, it should be used cautiously with monoamine oxidase inhibitors such as tranylcypromine. Because metoclopramide inhibits plasma cholinesterase, it increases the effectiveness of succinylcholine, a skeletal muscle relaxant. 

A study in 7 subjects found that 20 mg of intravenous metoclopramide increased the rate of alcohol absorption, and the peak blood levels were raised from 55 to 86 mg%. Similar results were seen in 2 healthy subjects given metoclopramide orally. Another study in 7 healthy subjects found that 10 mg of intravenous metoclopramide accelerated the rate of absorption of alcohol 70 mg/kg given orally, and increased its peak levels, but not to a statistically significant extent. Blood alcohol levels remained below 12 mg%. More importantly the sedative effects of the alcohol were increased. The reasons for this effect are not fully understood, but it appears to be related to an increase in gastric emptying. These two studies were done to find out more about intestinal absorption mechanisms rather than to identify daily practicalities, so the importance of the findings is uncertain. However, it seems possible that the effects of alcohol will be increased. Metoclopramide alone can sometimes cause drowsiness, and if affected, patients should not drive or operate machinery. 

Metoclopramide speeds up gastric emptying. The relatively poorly soluble ketoprofen spends less time in the stomach where it dissolves, and as a result less is available for absorption in the small intestine. Conversely, the absorption rate of tolfenamic acid is increased, without a change in the extent of absorption. 

Metoclopramide increases the rate of gastric emptying so that the rate of morphine absorption from the small intestine is increased. An alternative idea is that both drugs act additively on opiate receptors to increase sedation. Droperidol may also enhance adverse effects such as sedation, and in some cases respiratory depression, possibly through opioid and other receptor sites in the CNS. In one case the respiratory depression was not reversed by naloxone, suggesting that the droperidol was at least partially if not completely responsible. ... 

When 14 kidney transplant patients were given metoelopramide their peak ciclosporin blood levels were ineieased by 46%, from 388 to 567 nanograms/mL and the ciclosporin AUC was increased by 22%. The dosage of metoclopramide was 10 mg by mouth 30 minutes before, 5 mg with, and 5 mg 30 minutes after the morning dose of ciclosporin. Ciclosporin is largely absorbed by the small intestine so the likely mechanism for this interaction is increased absorption of ciclosporin because metoclopramide hastens gastric emptying. The clinical importance of this interaction is uncertain. Concurrent use should be well monitored to ensure that any increase in ciclosporin peak levels does not increase adverse effects. Note that the increase in the AUC of ciclosporin is only modest. 

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