title: Metoclopramide: pharmacology and clinical application.
abstract: Metoclopramide antagonizes the effect of dopamine in the central nervous system and other organ systems. Metoclopramide's effect on the medullary chemoreceptor trigger zone makes it useful as a routine anti-emetic and in preventing vomiting induced by antineoplastic drugs, particularly cisplatin. Metoclopramide's gastrointestinal smooth muscle stimulatory effects are related to its ability to antagonize the inhibitory neurotransmitter, dopamine; to augment acetylcholine release and sensitize the muscarinic receptors of the gastrointestinal smooth muscle; and to coordinate gastric-pyloric-small intestinal motor function. The indications for which metoclopramide is approved in the United States are reviewed. Adverse effects, which may occur in up to 20% of patients, include drowsiness, lassitude, and akathisia; all are usually mild, transient, and reversible. Tremor, dystonic reactions, and extrapyramidal effects are infrequent; breast enlargement, galactorrhea, and menstrual irregularities are related to prolactin release.
mesh_terms: D000856:Anorexia Nervosa / Q000188:drug therapy; D000932:Antiemetics / Q000494:pharmacology; D003920:Diabetes Mellitus / Q000503:physiopathology; D018492:Dopamine Antagonists; D004702:Endocrine Glands / Q000187:drug effects; D005746:Gastric Emptying / Q000187:drug effects; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006801:Humans; D007415:Intestinal Obstruction / Q000188:drug therapy; D008787:Metoclopramide / Q000009:adverse effects / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D009130:Muscle, Smooth / Q000187:drug effects; D010277:Parasympathomimetics / Q000494:pharmacology; D011183:Postoperative Complications; D013276:Stomach Ulcer / Q000188:drug therapy
chemical_list: D000932:Antiemetics; D018492:Dopamine Antagonists; D010277:Parasympathomimetics; D008787:Metoclopramide