The Experts below are selected from a list of 20406 Experts worldwide ranked by ideXlab platform
Michael Camilleri - One of the best experts on this subject based on the ideXlab platform.
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review article Metoclopramide and tardive dyskinesia
Alimentary Pharmacology & Therapeutics, 2010Co-Authors: Archana Rao, Michael CamilleriAbstract:Summary Background Metoclopramide is a dopamine receptor antagonist which has been used for treatment of a variety of gastrointestinal symptoms over the last thirty years. In 2009, the FDA issued a black box warning regarding long-term or high-dose use of this medication because of the risk of developing tardive dyskinesia. Aims To review the mechanism of action and pharmacokinetic properties of Metoclopramide, the risk of Metoclopramide-induced tardive dyskinesia, potential mechanisms that may alter and to summarize the clinical context for appropriate use of the drug. Methods We conducted a PubMed search using the following key words and combined searches: Metoclopramide, neuroleptics, tardive dyskinesia, incidence, prevalence, dopamine, receptors, pharmacokinetic, pharmacology, pharmacogenetics, DRD3 Ser9Gly polymorphism, cytochrome P450, p-glycoprotein, risk factors, gastroparesis, outcome, natural history. Results Available data show that risk of tardive dyskinesia from Metoclopramide use is likely to be <1%, much less than the estimated 1–10% risk previously suggested in national guidelines. Tardive dyskinesia may represent an idiosyncratic response to Metoclopramide; pharmacogenetics affect pharmacokinetic and dopamine receptor pharmacodynamics in response to neuroleptic agents that cause similar neurological complications. Conclusion Community prevalence and pharmacogenetic mechanisms involved in Metoclopramide-induced tardive dyskinesia require further study to define the benefit-risk ratio more clearly.
Laura A Magee - One of the best experts on this subject based on the ideXlab platform.
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Metoclopramide for nausea and vomiting of pregnancy a prospective multicenter international study
American Journal of Perinatology, 2002Co-Authors: Matitiahu Berkovitch, Paul Mazzota, Revital Greenberg, Daniel Elbirt, Antony Addis, Lavinia Schulerfaccini, Paul Merlob, Judy Arnon, Bracha Stahl, Laura A MageeAbstract:Nausea and vomiting are very common during pregnancy, mainly throughout the first trimester. Metoclopramide is a dopamine receptor blocking drug that is commonly used to treat nausea and vomiting. The aim of this prospective study was to investigate the effect on the fetus of intrauterine exposure to Metoclopramide. One hundred and seventy-five women who received Metoclopramide and consulted 6 teratogen information centers in Israel, Italy, Brazil, and Canada were studied. Women exposed to Metoclopramide were paired for age, smoking and alcohol consumption habits with women exposed to nonteratogens. Women in the Metoclopramide group had a significantly higher rate of premature births (8.1%) as compared with the control group (2.4%) ( p = 0.02, relative risk = 3.37, 95% confidence interval 1.12-10.12). Rates of major malformations in the Metoclopramide group (4.4%) did not differ from controls (4.8%) ( p = 0.84, relative risk = 0.91, 95% confidence interval 0.34-2.45). According to our findings, Metoclopramide use during the first trimester of pregnancy does not appear to be associated with an increased risk of malformations, spontaneous abortions, or decreased birth weight, however, larger studies are needed to confirm these observations.
J Boldt - One of the best experts on this subject based on the ideXlab platform.
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placebo controlled comparison of dolasetron and Metoclopramide in preventing postoperative nausea and vomiting in patients undergoing hysterectomy
European Journal of Anaesthesiology, 2001Co-Authors: Swen N. Piper, J. G. Triem, Wolfgang H. Maleck, M T Fent, I Huttner, J BoldtAbstract:Summary Background and objective In a randomized, placebo-controlled, double-blind trial, we compared the efficacy of dolasetron and Metoclopramide in preventing postoperative nausea and vomiting in women undergoing hysterectomy. Methods Patients were allocated randomly to one of three groups: group A (n = 50) received 50 mg dolasetron orally, group B (n = 50) received 20 mg Metoclopramide intravenously and placebo orally, group C (n = 50) received placebo orally. If patients complained of retching or vomiting, or if patients demanded an antiemetic, 1.25 mg droperidol was administrated intravenously. To quantify postoperative nausea and vomiting the following score was used: 0 = no nausea, 1 = nausea, 2 = retching, 3 = single vomiting, 4 = multiple vomiting. The Raatz test was used to analyse postoperative nausea and vomiting (PONV) scores. Results Dolasetron reduced the postoperative nausea and vomiting score significantly (P < 0.02 vs. Metoclopramide; P < 0.0001 vs. placebo). Metoclopramide also reduced the postoperative nausea and vomiting score (P < 0.02 vs. placebo). Fisher's exact test showed a significant reduction of vomiting in the dolasetron group compared with Metoclopramide-treated patients (P < 0.007) and placebo-treated patients (P < 0.000006) and a significantly lower rate of nausea in comparison to the placebo group (P < 0.009). There were no significant differences between the Metoclopramide and the placebo groups (in Fisher's exact test). The use of postoperative droperidol per patient was significantly lower in the dolasetron group (P < 0.04 vs. Metoclopramide; P < 0.0001 vs. placebo) than in the Metoclopramide (P < 0.02 vs. placebo) and in the placebo groups. Conclusions Oral dolasetron is more effective than either Metoclopramide given intravenously or placebo for preventing vomiting after hysterectomy. It also was significantly superior to either Metoclopramide or placebo concerning the PONV score and the need for droperidol rescue.
Souei Sekiya - One of the best experts on this subject based on the ideXlab platform.
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Corticotrophin and vasopressin responses to Metoclopramide in patients with hypothalamic amenorrhoea
Clinical endocrinology, 1997Co-Authors: Katsuyoshi Seki, T. Kato, Souei SekiyaAbstract:OBJECTIVE A dopamine (DA) antagonist, Metoclopramide, stimulates ACTH secretion in some women with hypothalamic amenorrhoea (HA) but not in normal women. Metoclopramide may stimulate ACTH secretion by decreasing dopaminergic inhibition of ACTH release. Furthermore, Metoclopramide stimulates AVP secretion, and AVP is a stimulator of ACTH. Therefore, AVP may also be involved in the ACTH responses to Metoclopramide. The relation between AVP and ACTH responses to Metoclopramide were evaluated in normal women and women with HA to obtain more insight into the role of DA in the regulation of ACTH and AVP secretion. DESIGN ACTH, cortisol and AVP levels were measured before and after the administration of Metoclopramide in 11 normal women during the early follicular phase and 12 women with HA. MEASUREMENTS ACTH was measured by immunoradiometric assay. AVP and cortisol were measured by radioimmunoassay. RESULTS The administration of Metoclopramide significantly increased circulating levels of ACTH and cortisol in the women with HA, but not in the normal women. It increased AVP levels both in the normal women and in the women with HA. The incremental AVP response to Metoclopramide was not significantly different between the two groups of women. CONCLUSION The effect of Metoclopramide on AVP secretion may not be dependent on central dopaminergic activity, and the ACTH and cortisol responses to Metoclopramide in the women with hypothalamic amenorrhoea are not accounted for by the augmented AVP response to Metoclopramide.
Archana Rao - One of the best experts on this subject based on the ideXlab platform.
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review article Metoclopramide and tardive dyskinesia
Alimentary Pharmacology & Therapeutics, 2010Co-Authors: Archana Rao, Michael CamilleriAbstract:Summary Background Metoclopramide is a dopamine receptor antagonist which has been used for treatment of a variety of gastrointestinal symptoms over the last thirty years. In 2009, the FDA issued a black box warning regarding long-term or high-dose use of this medication because of the risk of developing tardive dyskinesia. Aims To review the mechanism of action and pharmacokinetic properties of Metoclopramide, the risk of Metoclopramide-induced tardive dyskinesia, potential mechanisms that may alter and to summarize the clinical context for appropriate use of the drug. Methods We conducted a PubMed search using the following key words and combined searches: Metoclopramide, neuroleptics, tardive dyskinesia, incidence, prevalence, dopamine, receptors, pharmacokinetic, pharmacology, pharmacogenetics, DRD3 Ser9Gly polymorphism, cytochrome P450, p-glycoprotein, risk factors, gastroparesis, outcome, natural history. Results Available data show that risk of tardive dyskinesia from Metoclopramide use is likely to be <1%, much less than the estimated 1–10% risk previously suggested in national guidelines. Tardive dyskinesia may represent an idiosyncratic response to Metoclopramide; pharmacogenetics affect pharmacokinetic and dopamine receptor pharmacodynamics in response to neuroleptic agents that cause similar neurological complications. Conclusion Community prevalence and pharmacogenetic mechanisms involved in Metoclopramide-induced tardive dyskinesia require further study to define the benefit-risk ratio more clearly.