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  metoclopramide (Reglan) PHARMACOLOGIC CLASS: Dopamine  –   2 receptor antagonist Method of Action Metoclopramide is a prokinetic drug that stimulates the muscles of the gastrointestinal tract by interacting with receptors for acetylcholine and dopamine on gastrointestinal muscles and nerves. It also stimulates the muscles of the stomach and thereby hastens emptying of solid and liquid meals from the stomach and into the intestines.  Indications    Chemotherapy-induced nausea & vomiting    Diabetic Gastroparesis    Small Bowel Intubation    Gastroesophageal Reflux Disease    Post-op nausea and vomiting Contraindications    History of tardive dyskinesia (TD)    Dystonic reaction to metoclopramide    GI obstruction, perforation or hemorrhage    Pheochromocytoma    Epilepsy Side Effects    Drowsiness      Restlessness      Fatigue      Anxiety      Insomnia      Depression      Sedation    Adverse Effects      Parkinsonism      Akathisia      Seizures      Hallucinations      Hypertension      Fluid retention      Hyperprolactinemia      Hypersensitivity reactions  Patient Teaching    Store tablets and syrups between 15 degrees Celsius to 30 degrees Celsius. Injectable metoclopramide should be stored at room temperature (20 degrees Celsius to 25 degrees Celsius)      The usual dose of metoclopramide for treating GERD is 10  –   15 mg, four times daily and 30 minutes before each meal.      Gastroparesis is treated with 10 mg administered orally four times daily, 30 minutes before each meal and at bedtime.      Do not take with anticholinergic drugs as it can decrease the effectiveness of metoclopramide.  Special Precautions    Patients with Parkinson’s disease can experience worsening of the symptoms with metoclopramide.    Metoclopramide may impair the mental or physical abilities to drive or operate heavy machinery.      Metoclopramide may decrease the concentrations of digoxin and cimetidine in the blood if taken together.      Nursing mothers should avoid metoclopramide during pregnancy since it is also excreted in human milk.  
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