Metoclopramide

Metoclopramide

Introduction :

Generic Name :

Metoclopramide

Brand Names : 

Reglan

Availability :

Injection : 5mg/ml
Syrup      : 5mg/ml
Tablets    : 5mg, 10mg

Classification :

Antiemetics

Action :

• Stimulates motility of upper G.I tract,
• Increases lower esophageal sphincter tone.
• Blocks dopamine receptors at the chemoreceptor trigger zone.

Indication :

Emesis during pregnancy

Dosage : 

Adults : 5 - 10mg

Contra Indication :

• Contraindicated to patients hypersensitive to drug and in those with phechromocytoma or seizure disorders.
• Contraindicated in patients for whom stimulation on of G.I motility might be dangerous ( those with hemorrhage, obstruction, or perforation.
• Use cautiously in patients with history of depression, parkinson's disease or hypertesion.

Adverse Effects  :

CNS :

Restlessness, anxiety, drowsiness, fatigue, lassitude, fever, depression, akathisia, insomnia confusion, suicide i ideation, seizures, neuroletic malignant syndrome, hallucinations, headache, dizziness.

CV :

transient hypertension,

Hypertension on superaventricular tachycardia, bradycardia.

GI :

nausea, bowel disorders, diarrhea.

GU :

Urinary frequency, incontinence.

Hematologic :

neutroenia.

Skin :

Rash, urticaria.

Other :

Prolactin secretion,

Loss of libido.

Nursing Responsibility / Intervention  :

• Monitor bowel sounds.
• safety and effectiveness of drug haven't been established for therapy lasting longer than 12 weeks.
• when oral solution is used ( 10mg/ml) dilute in pudding, applesauce, juice, or water just before using.
• Alert : Use diphenhydramine 25mg IV.

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Age Groups

Age Groups

Peadiatric Age Groups

Premature Newborns :

          < 38 weeks gestational age

Term Newborns :

          >38 weeks gestational age

Neonate :

          0 - 30 days of age

Infant :

          1month - 2 years

Young child :

          2 years - 6 years

Child :

          6 years -  12 years

Adolescent :

          12 - 18 years

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Nursing Diagnosis : 

01. Deficit fluid volume  and electrolyte imbalance related to  excessive vomiting or lack fluid intake as manifested by vomiting, dry skin.

Assessment : 

A. SUBJECTIVE DATA ;

The patient verbalizes that

B.OBJECTIVE DATA :

- Nausea
- Irritation
- Vomiting
- Dry Skin

Goal :

Planning :

- Assess the level of patient condition, sign and symptoms, fluid volume deficit,   Including dry mucous membrane, dry skin, poor turgor, concentrated urine, sunken eyes, oliguria, malaise, hypotension, syncope, vertigo,
- Provide comfort position.
- Provide comfortable environment
- Administer balanced Iv fluids.
- Administer and document the medication (Metoclopramide ) as prescribed by the physician.
- Encourage the patient to increase intake of oral fluids.
- Encourage the patient to eat dry toast foods.

Rational :

- To determine the level of condition.
- To gathering the base line data.
-  For relaxation of the patient
- To prevent the dehydration of the patient.
- To prevent discomfort, irritation of the patient.
- To provide wellness of patient.

Interventions :

- Assessed the level of patient condition.
- Monitored vital signs and record.
- Provided supine position.
- Maintained quit and calm environment.
- Administered iv fluids.
- Encouraged the patient to eat dry toast food like toast bread.

Evaluation :

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