7 facts on metoclopramide utility

2020 ◽  
Vol 13 (4) ◽  
pp. 498-502
Author(s):  
Marek Bugajski
Keyword(s):  
Randomized Clinical Trials ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Adverse Outcomes ◽  
Nausea And Vomiting ◽  
Evidence Based ◽  
Effective Agent ◽  
Serious Adverse Events ◽  
Inhibition Effect ◽  
Pyramidal Syndrome

Nausea and vomiting can be either a symptom, or an adverse reaction to treatment. Metoclopramide is an effective agent that can be used to treat nausea and vomiting due to inhibition effect on dopamine D2 receptor and histamine 5-HT3 receptor, causing accelerated gastric emptying, as well as increased gut motility. It is effective in treatment of nausea and vomiting regardless of cause. Some conditions with evidence (based on randomized clinical trials) of metoclopramide effectiveness include migraine, diabetic gastroparesis, patients after chemo- or radiotherapy, after surgery. Even though there is a risk of serious adverse events (including extra-pyramidal syndrome), metoclopramide can be regarded as safe, assuming appropriate patient selection. It can be used also during pregnancy, as well as in pediatric setting, where long-lasting adverse outcomes are observed extremely rarely.

Dopamine D2 receptor Taq IA polymorphism is associated with postoperative nausea and vomiting

2008 ◽  
Vol 22 (4) ◽  
pp. 397-403 ◽  
Author(s):  
Masashi Nakagawa ◽  
Michioki Kuri ◽  
Noriko Kambara ◽  
Hironobu Tanigami ◽  
Hideo Tanaka ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Dopamine D2

scholarly journals Indirect Meta-Analysis of Brexpiprazole Versus Aripiprazole in the Acute Treatment of Schizophrenia

2021 ◽  
Author(s):  
Erich Seifritz ◽  
Michael Friede ◽  
Jörg Schnitker
Keyword(s):  
Adverse Events ◽  
Acute Treatment ◽  
Dopamine D2 Receptor ◽  
Meta Analysis ◽  
D2 Receptor ◽  
Number Needed To Treat ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Safety Indices ◽  
Number Needed To Harm

Abstract Background: Brexpiprazole and aripiprazole are atypical antipsychotics that act as partial agonists at the dopamine D2 receptor. No head-to-head trial comparing brexpiprazole and aripiprazole in the treatment of schizophrenia is available. Here, we carry out a systematic review and comparison of the efficacy and safety of brexpiprazole and aripiprazole in schizophrenia treatment.Methods: We employed an indirect meta-analysis to determine effect sizes from randomised placebo-controlled trials with brexpiprazole and aripiprazole in the acute treatment of schizophrenia. We compared responder rates, incidences of adverse events and serious adverse events, the number needed to treat (NNT) for response, number needed to harm (NNH) for adverse events or treatment discontinuation, and likelihood to be helped or harmed (LHH) as efficacy and safety indices of the two drugs. Results: Five studies for each drug were included in the analysis. Similar risk differences vs. placebo were observed for responder rates under brexpiprazole (10.2%, p = 0.0015) and aripiprazole (10.3%, p = 0.0003). Higher incidences of adverse events and serious adverse events were seen under aripiprazole compared with brexpiprazole, however, the risk differences were not statistically significant. The NNT for response was 11 for both substances. For brexpiprazole compared with placebo, we did not find an increase of adverse events (NNH = 27, not significant), however, we found an increased number of adverse events for aripiprazole versus placebo (NNH = 17, p < 0.05). For both drugs, benefits were encountered more often than harms, with an LHH for any adverse event of 2.41 for brexpiprazole and 1.56 for aripiprazole, respectively. Conclusions: The likelihood to be helped rather than harmed was greater with brexpiprazole compared to aripiprazole for the total rate of adverse events (ratio of brexpiprazole LHH/aripiprazole LHH = 1.54).

Influence of cytochrome P450 genotype on the plasma disposition of prochlorperazine metabolites and their relationships with clinical responses in cancer patients

2017 ◽  
Vol 55 (3) ◽  
pp. 385-393 ◽  
Author(s):  
Masaki Tashiro ◽  
Takafumi Naito ◽  
Yoshiyuki Kagawa ◽  
Junichi Kawakami
Keyword(s):  
Cancer Patients ◽  
Dopamine D2 Receptor ◽  
Plasma Concentrations ◽  
D2 Receptor ◽  
Parent Drug ◽  
Prolactin Secretion ◽  
Nausea And Vomiting ◽  
Serum Prolactin ◽  
Antiemetic Efficacy ◽  
Clinical Responses

Background Oral prochlorperazine, a dopamine D2 receptor antagonist, is largely metabolized to sulphoxide, 7-hydroxylate and N-desmethylate by cytochrome P450s (CYPs). This study evaluated the influence of CYP genotype on the plasma dispositions of prochlorperazine and its metabolites and their relationships with antiemetic efficacy and prolactin elevation in cancer patients. Methods Forty-eight cancer patients treated with oral prochlorperazine were enrolled. Plasma prochlorperazine and its metabolites concentrations and serum prolactin concentration were determined at 12 h after the evening dosing. The genotypes of CYP2C19, CYP2D6 and CYP3A5 and the incidences of nausea and vomiting were investigated. Results The plasma concentrations of the prochlorperazine metabolites were weakly correlated with that of the parent drug. The CYP genotypes did not affect the plasma concentrations of prochlorperazine and its metabolites. The plasma concentrations of prochlorperazine and its metabolites were not associated with the incidences of nausea and vomiting. The incidence of vomiting was significantly higher in females than in males. The serum prolactin concentration was weakly correlated with the plasma concentrations of prochlorperazine and its metabolites. The plasma concentrations of prochlorperazine metabolites rather than the parent drug had a weaker relation to serum prolactin concentration. Conclusions The CYP genotypes did not affect the plasma dispositions of prochlorperazine and its metabolites. The prochlorperazine metabolites did not have a strong effect on antiemetic efficacy, while they were slightly associated with prolactin secretion in cancer patients.

Research Consumerism 101: Evaluating External Evidence of Treatment Effectiveness

2008 ◽  
Vol 17 (2) ◽  
pp. 43-49
Author(s):  
James L. Coyle
Keyword(s):  
Treatment Effectiveness ◽  
Code Of Ethics ◽  
Oropharyngeal Dysphagia ◽  
Clinical Importance ◽  
Professional Services ◽  
Adverse Outcomes ◽  
Professional Judgment ◽  
Evidence Based ◽  
Intervention Selection ◽  
Published Research

Abstract The modern clinician is a research consumer. Rehabilitation of oropharyngeal impairments, and prevention of the adverse outcomes of dysphagia, requires the clinician to select interventions for which evidence of a reasonable likelihood of a successful, important outcome exists. The purpose of this paper is to provide strategies for evaluation of published research regarding treatment of oropharyngeal dysphagia. This article utilizes tutorial and examples to inform and educate practitioners in methods of appraising published research. It provides and encourages the use of methods of efficiently evaluating the validity and clinical importance of published research. Additionally, it discusses the importance of the ethical obligation we, as practitioners, have to use evidence-based treatment selection methods and measurement of patient performance during therapy. The reader is provided with tactics for evaluating treatment studies to establish a study's validity and, thereby, objectively select interventions. The importance of avoiding subjective or unsubstantiated claims and using objective methods of generating empirical clinical evidence is emphasized. The ability to evaluate the quality of research provides clinicians with objective intervention selection as an important, essential component of evidence-based clinical practice. ASHA Code of Ethics (2003): Principle I, Rule F: “Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed…” (p. 2) Principle I, Rule G: “Individuals shall evaluate the effectiveness of services rendered and of products dispensed and shall provide services or dispense products only when benefit can reasonably be expected.” (p. 2) Principle IV, Rule G: “Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription.” (p. 4)

Effect of amphetamine on dopamine D2 receptor binding in the primate brain with the agonist ligand [11C]MNPA

2005 ◽  
Vol 25 (1_suppl) ◽  
pp. S646-S646
Author(s):  
Nicholas Seneca ◽  
Sjoerd Finnema ◽  
Masanori Ichise ◽  
Balazs Gulyas ◽  
Håkan Wikstrom ◽  
...  
Keyword(s):  
Receptor Binding ◽  
Dopamine D2 Receptor ◽  
D2 Receptor ◽  
Dopamine D2 ◽  
Primate Brain

Assessment of endocrine disorders of the hypothalamicpituitary axis by nuclear medicine techniques

2002 ◽  
Vol 41 (02) ◽  
pp. 80-90 ◽  
Author(s):  
F. Jockenhövel ◽  
P. Theissen ◽  
M. Dietlein ◽  
W. Krone ◽  
H. Schicha ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Pituitary Adenomas ◽  
Dopamine D2 Receptor ◽  
Somatostatin Receptor ◽  
D2 Receptor ◽  
Ectopic Acth Syndrome ◽  
Endocrine Disorders ◽  
Ectopic Acth ◽  
Number Of Patients ◽  
Hypothalamic Pituitary Axis

SummaryThe following article reviews nuclear medicine techniques which can be used for assessment of endocrine disorders of the hypothalamic-pituitary axis. For planar and SPECT imaging somatostatin-receptor- and dopamine- D2-receptor-scintigraphy are the most widely distributed techniques. These nuclear medicine techniques may be indicated in selected cases to answer differential diagnostic problems. They can be helpful to search for presence and localization of receptor positive tissue. Furthermore they can detect metastasis in the rare cases of a pituitary carcinoma. Scintigraphy with Gallium-67 is suitable for further diagnostic evaluation in suspected hypophysitis. Other SPECT radiopharmaca do not have relevant clinical significance. F-18-FDG as PET radiopharmacon is not ideal because obvious pituitary adenomas could not be visualized. Other PET radiopharmaca including C-11-methionine, C-11-tyrosine, F-18-fluoroethylspiperone, C-11-methylspiperone, and C-11-raclopride are available in specialized centers only. Overall indications for nuclear medicine in studies for the assessment of endocrine disorders of the hypothalamic-pituitary-axis are rare. Original studies often report only about a small number of patients. According to the authors’ opinion the relevance of nuclear medicine in studies of clinically important endocrinologic fields, e. g. localization of small ACTH-producing pituitary adenomas, tumor localization in ectopic ACTH syndrome, localization of recurrent pituitary tissue, assessment of small incidentalomas, can not be definitely given yet.

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