Metoclopramide
 
Presentation
• 10mg in 2ml ampoule
Pharmacology
• Antiemetic
Actions
• Accelerates gastric emptying and peristalsis
• Mild SHT3-receptor antagonist
Metabolism
• By the liver and excreted by the kidneys
Primary Emergency Indications
• Nausea/vomiting Adult associated with:
  - Chest pain/discomfort of a cardiac nature
  - Opioid administration for pain
  - Previously diagnosed Migraine
  - Cytotoxic or radiotherapy
  - Severe gastroenteritis
  - Treatment or prophylaxis in awake spinal immobilised Pts
  - Eye trauma
Contraindications
• Children
• Suspected bowel obstruction or perforation
• Gastrointestinal haemorrhage
Precautions
• Undiagnosed abdominal pain
• Adolescents (<20yrs)
• Administer slowly over one minute to minimise risk of extrapyramidial reactions
Route of Administration
• IV
• IM
Side Effects
• Drowsiness
• Lethargy
• Dry mouth
• Muscle tremor
• Extrapyramidial reactions (usually the dystonic type)
Special Notes
• Not effective for established motion sickness
• Not effective for nausea prophylaxis in the setting of narcotic administration
Therapeutic Effect
IV     
Onset:
1-3min
Peak:
Duration:
10-30min
 
IM     
Onset:
10-15min
Peak:
Duration:
1-2hr