Podcasts about metoclopramide

Contributor: Taylor Lynch, MD Educational Pearls: What is NMS? Neuroleptic Malignant Syndrome Caused by anti-dopamine medication or rapid withdrawal of pro-dopamenergic medications Mechanism is poorly understood Life threatening What medications can cause it? Typical antipsychotics Haloperidol, chlorpromazine, prochlorperazine, fluphenazine, trifluoperazine Atypical antipsychotics Less risk Risperidone, clozapine, quetiapine, olanzapine, aripiprazole, ziprasidone Anti-emetic agents with anti dopamine activity Metoclopramide, promethazine, haloperidol Not ondansetron Abrupt withdrawal of levodopa How does it present? Slowly over 1-3 days (unlike serotonin syndrome which has a more acute onset) Altered mental status, 82% of patients, typically agitated delirium with confusion Peripheral muscle rigidity and decreased reflexes. AKA lead pipe rigidity. (As opposed to clonus and hyperreflexia in serotonin syndrome) Hyperthermia (>38C seen in 87% of patients) Can also have tachycardia, labile blood pressures, tachypnea, and tremor How is it diagnosed? Clinical diagnosis, focus on the timing of symptoms No confirmatory lab test but can see possible elevated CK levels and WBC of 10-40k with a left shift What else might be on the differential? Sepsis CNS infections Heat stroke Agitated delirium Status eptilepticus Drug induced extrapyramidal symptoms Serotonin syndrome Malignant hyperthermia What is the treatment? Start with ABC's Stop all anti-dopaminergic meds and restart pro-dopamine meds if recently stopped Maintain urine output with IV fluids if needed to avoid rhabdomyolysis Active or passive cooling if needed Benzodiazapines, such as lorazepam 1-2 mg IV q 4hrs What are active medical therapies? Controversial treatments Bromocriptine, dopamine agonist Dantrolene, classically used for malignant hyperthermia Amantadine, increases dopamine release Use as a last resort Dispo? Mortality is around 10% if not recognized and treated Most patients recover in 2-14 days Must wait 2 weeks before restarting any medications References Oruch, R., Pryme, I. F., Engelsen, B. A., & Lund, A. (2017). Neuroleptic malignant syndrome: an easily overlooked neurologic emergency. Neuropsychiatric disease and treatment, 13, 161–175. https://doi.org/10.2147/NDT.S118438 Tormoehlen, L. M., & Rusyniak, D. E. (2018). Neuroleptic malignant syndrome and serotonin syndrome. Handbook of clinical neurology, 157, 663–675. https://doi.org/10.1016/B978-0-444-64074-1.00039-2 Velamoor, V. R., Norman, R. M., Caroff, S. N., Mann, S. C., Sullivan, K. A., & Antelo, R. E. (1994). Progression of symptoms in neuroleptic malignant syndrome. The Journal of nervous and mental disease, 182(3), 168–173. https://doi.org/10.1097/00005053-199403000-00007 Ware, M. R., Feller, D. B., & Hall, K. L. (2018). Neuroleptic Malignant Syndrome: Diagnosis and Management. The primary care companion for CNS disorders, 20(1), 17r02185. https://doi.org/10.4088/PCC.17r02185 Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSIII  

On this podcast episode, I finish up my breakdown of the Beers Criteria. I cover the use of sliding-scale insulin and sulfonylureas in geriatric patients. Hypoglycemia is a major concern with both of these diabetes management strategies. PPIs show up on the Beers criteria list as they can increase the risk of C. diff, pneumonia, fractures, and GI malignancies. Metoclopramide has dopamine antagonist activity and can increase the risk of EPS and tardive dyskinesia.

Get ahead with VETAHEAD and join Dr. Proença on 15 minutes of ZooMed (exotics) content. Today, let's welcome our Dr. Miranda Sadar (DACZM) and learn about how metoclopramide shouldn't be used in rabbits with GI syndrome.   Do you want to access more ZooMed (exotics) knowledge directly from specialists? Come with us and #jointhemovement #nospeciesleftbehind VETAHEAD Website: https://www.vetahead.vet/?utm_source=... Instagram: https://www.instagram.com/the_vetahead/ Facebook: https://www.facebook.com/vetahead YouTube https://www.youtube.com/channel/UCS0irRjbx1UXe495jo7l5GA?utm_source=default&utm_medium=email&utm_id=convertkit.com

Evoke Pharma CEO Dave Gonyer joined Steve Darling from Proactive to share news the company has achieved a significant milestone with the listing of its recently issued U.S. patent related to GIMOTI in the U.S. Food and Drug Administration's publication, commonly known as the "Orange Book." This development is of great importance as patents listed in the Orange Book cover drugs that the FDA has approved and deemed safe and effective for public use. The patent, titled "Nasal Formulations of Metoclopramide," pertains to a collection of nasal solutions of metoclopramide and outlines its characteristics when formulated. This newly listed patent in the FDA's Orange Book carries a patent term extending until 2029. Its inclusion adds an additional layer of patent protection for GIMOTI, complementing the three prior patents listed. This achievement underscores Evoke Pharma's commitment to advancing its innovative metoclopramide nasal spray, GIMOTI, which is designed to provide a treatment option for patients suffering from gastroparesis. The FDA's recognition of the patent's significance reaffirms GIMOTI's potential to address the unmet medical needs of patients. Furthermore, Dave Gonyer shared insights into the company's recent financial performance, reporting a remarkable 38% increase compared to Q2 2023 and an impressive 88% increase year-over-year in Q3. These positive financial results set the stage for Evoke Pharma's ambitious growth plans for 2024. As Evoke Pharma continues to make strides in the pharmaceutical industry, its commitment to innovation, patient care, and expanding its patent portfolio positions the company for further success in the years ahead. Investors and stakeholders can look forward to the company's continued growth and contributions to improving patient outcomes. #proactiveinvestors #evokepharmainc #nasdaq #evok #gastrointestinaldiseases #Gimoti #DiabeticGastroparesis #HealthcareInnovation #MedicalBreakthrough #PatientCare #Pharmaceuticals #NasalSprayTreatment #CEOInterview #RealWorldData #MedicalConference #Neuropathy #HealthTech #ChronicIllness #InnovationInMedicine #HealthcareIndustry #MedicalResearch #TreatmentAdvancements #CostSavings #HospitalizationReduction #MedicalNews #HealthTechUpdate #Gastroenterology #DrugDevelopment #Year2023Update #invest #investing #investment #investor #stockmarket #stocks #stock #stockmarketnews

In this episode, we review the high-yield topic of ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Metoclopramide⁠⁠⁠ from the Gastrointestinal section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message

In this episode, we review the high-yield topic of Metoclopramide ⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Gastrointestinal section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/MetoclopramideReglanNursingConsiderations      Generic Name metoclopramide Trade Name Reglan Indication prevention of nausea, vomiting, hiccups, migraines, gastric stasis Action accelerates gastric emptying by stimulating motility Therapeutic Class antiemetic Pharmacologic Class Dopamine D2 receptor antagonist, prokinetic Nursing Considerations • do not use with GI obstruction • may cause extrapyramidal reaction, neurolyptic malignant syndrome, tardive dyskinesia, arrhythmias, blood pressure alterations, hematologic alterations, facial movements, sedation • can decrease effects of levodopa • assess nausea/vomiting • monitor liver function tests

Trade – Reglan Class – Antiemetic MOA – promotes gastric emptyingIndication – Nausea/vomiting, Migraine with historyContraindication – GI obstruction or perforation, pregnancy, under 6 yo.Side effects – constipation, diarrhea, dry mouth, HTNDosingAdult 10-15mg IV,IOPediatric 0.4-0.8mg/kg IV/IO

Migraines are no longer considered a vascular headache and now considered a neurologic disorder of dysfunctional nociceptive processing.  Diagnosis is completed clinically with no lab or imaging usually needed.  Treatment includes - Antidopaminergics (Metoclopramide & Prochlorperazine) - Triptans (Sumatriptan) - Nonsteroidals (Ketorolac).  Consider steroids to lessen the risk of recurrence.  Opioids should be avoided and are last line. Most patients don't need specialist referral.  To learn more, visit https://courses.ccme.org/course/em-prep

This episode covers metoclopramide!

What is the most effective agent for relieving nausea and vomiting in the ER? The answer may surprise you…Please click HERE to leave a review of the podcast!References:All references for Episode 42 are found on my Read by QxMD collection

Metoclopramide Pharmacology Metoclopramide can block dopamine receptors as part of it's mechanism of action.  I discuss the clinical implications from this in the podcast. Metoclopramide can exacerbate Parkison's disorder so you need to be careful in that type of patient. Metoclopramide is dosed frequently, which can potentially be a downside as far as patient adherence goes. Metoclopramide has a few potential interactions that you should be aware of.  I talk about those in this episode. Be sure to check out The Thrill of the Case on Amazon as I do have a clinical scenario about Reglan (metoclopramide) in that 200+ page book. As always, check out my free Top 200 study guide!

Show notes at pharmacyjoe.com/episode342. In this episode, I’ll discuss three drug interactions every critical care pharmacist should know how to manage: 1. Linezolid and fentanyl (serotonin syndrome) 2. Metoclopramide and olanzapine (neuroleptic malignant syndrome) 3. Levofloxacin and sotalol (torsades) The post 342: Three drug interactions every critical care pharmacist should know how to manage appeared first on Pharmacy Joe.

Enter ASRA18 at PainExam for 20% off (until June 1, 2018) Headache Management with a focus on Fiorcet, Triptans and Metoclopramide   Download the PainExam App for iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another's health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. 
 Copyright © 2017 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.   Subscribe to our mailing list * indicates required Email Address *     References   Ann Emerg Med. 2011 May; 57(5): 475–82.e1. https://en.wikipedia.org/wiki/Fioricet https://en.wikipedia.org/wiki/Metoclopramide

New podcast on Headache Management with a focus on Fiorcet, Triptans and Metoclopramide -Enter ASRA18 at AnesthesiaExam for 20% off (until June 1, 2018)   AnesthesiaExam Podcast App For iPhone and Android  DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author. 
 
   Subscribe to our mailing list * indicates required Email Address *     References   Ann Emerg Med. 2011 May; 57(5): 475–82.e1. https://en.wikipedia.org/wiki/Fioricet https://en.wikipedia.org/wiki/Metoclopramide  

The post Metoclopramide (Reglan) Nursing Pharmacology Considerations appeared first on NURSING.com.

I've been there before. Panicking in the bathroom, wishing it wasn't true. It's a hard question to try to answer because nothing I say is going to make you feel magically better. If you're already sick then more than likely it's going to continue to some extent. But learning what works best for you and fighting it everyday could mean the difference between hospitalization and infection, or staying home. If you haven't done it already, I highly suggest you get a Doctor's appointment, the soonest available. Ask for medication and start taking it round the clock right away. If you haven't gotten sick yet, you could just have it on hand until it starts. For some people it's violent from the start. Keeping yourself out of a bad cycle of dehydration and vomiting and not eating is the overall goal. Medication to ask about: Zofran: (prescription) (ondansetron) Anti-emetic (it helps control the vomiting) Unisom: (Over the counter) (doxylamine) anti-histamine (helps control the nausea) Diclectin: (prescription) (Pyridoxine/doxylamine) which is unisom and B6 together in a time release capsule. Phenergan: (prescription) (Promethazine), (I.V., suppositories, pill) Reglan: (prescription) (Metoclopramide) dopamine-receptor antagonist. It can help with nausea and vomiting by helping with gastric emptying. It's often given to people with GERD. However, one adverse effect to watch out for is called tardive dyskinesia. It can also make you feel tired, restless and anxious. Gabapentin: (prescription) (Neurontin) anticonvulsant and analgesic, usually given to control seizure disorders or neurological pain. This is still being trialed and is not commonly prescribed. Adverse effects for pregnancy are unknown. Dealing with constipation as a side effect of medication, notably Zofran. You can ask your doctor for a stool softener to be proactive and try to prevent constipation from happening. You can also try milk of magnesia or another kind of magnesium pill or liquid. That can help in numerous ways, including getting some much needed magnesium. If you're already constipated, I would suggest doing more than that to try to get ahead of the problem. Glycerin suppositories (can be found in more drug stores in the U.S.) Enemas (like Fleets brand enema): It comes in a self contained package with saline. One time use. Willard water Saline warm water Magnesium oil: You can make it yourself. It's actually not an oil but a solution of equal parts magnesium chloride and filtered water. What would you tell someone with HG who just found out they were pregnant?  

This edition of PEM Currents focuses on the use of antiemetics to treat status migrainosus in the Pediatric ED. Prochlorperazine and Metoclopramide are safe and effective agents with a low incidence of self limited side effects that when given in combination with ketorolac result in over 90% of patient being headache free at 3 hours. […]

Interview with Björn Pasternak, MD, PhD, author of Metoclopramide in Pregnancy and Risk of Major Congenital Malformations and Fetal Death