Questions and Answers
Antiemetic drugs (4) - ANS Ondasteron
Dimenhydrinate
Metoclopramide
Diphenhydramine
Metoclopramide (Maxeran) classification (2) - ANS Antiemetic
modifier of upper GI tract motility
Metoclopramide (Maxeran) Actions (5) - ANS increases pressure in lower esophageal
sphincter increasing peristaltic movements in the esophagus, stomach, and small intestine
increases gastric emptying
relieves N/V
Antagonizes central and peripheral dopamine receptors, raising the threshold of activity in the
chemoreceptor zone- antiemetic effects
Used to counteract the gastric states and nausea associated with migraine
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,Metoclopramide (Maxeran) Indications - ANS N/V
Headache suggestive of being vascular in origin (migraine)
Metoclopramide (Maxeran) Contraindications (5) - ANS Hypersensitivity
GI obstruction
GI bleed
Seizure disorder
Concurrent use with other agents likely to increase extrapyramidal reactions
Metoclopramide (Maxeran) N/V dose (3) - ANS 10mg diluted in 50mL NS and infuse over 5
(five) mins NO REPEAT
or 10mg IM NO REPEAT
(10mg IM/IV q 8-12 hrs, prn)*
Metoclopramide (Maxeran) HA dose (2) - ANS 10mg diltued in 50mL NS and infuse over 15
(fifteen) mins NO REPEAT
or 10mg IM NO REPEAT
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, Metoclopramide (Maxeran) pharmacokinetics - ANS Half life: 3-5 hrs
Metoclopramide (Maxeran) Considerations (4) - ANS Maxeran can cause extrapyramidal
symptoms if administered to quickly:
A) Dyskinesia- repetitive, involuntary body/facial movements
B) Akathisia- extreme form of restlessness
C) Dystonia- very strong muscle contractions
Use with caution in pts with HTN, depression, parkinson's, elders (risk of dyskinesia), breast CA
Metoclopramide (Maxeran) Adverse effects (4) - ANS Drowsiness
dizziness
seizures
tachydysrhythmias
Dimenhydrinate (Gravol) Classification (2) - ANS Antiemetic
Antihistamine
Dimenhydrinate (Gravol) Actions (4) - ANS Depressant action on hyper stimulated
labyrinthine functions and diminishes vestibular function
Sedative effects due to inhibition of histamine and blockade of central histaminergic receptors
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