Antiemetic for pt with haemotemesis and maelena

[antc]

Not sure how many of you would use metoclopramide however, would you give Metoclopramide to a patient with the above presentation.

Why or why not?

[Ridryder 911]

We use Reglan routinely and actually our ER Doc's prefer it over phenergran and the cost is so much less than Zofran. If the patient is nauseated with hematemesis, sure I give it to them. It is a routine drug given with GI bleeds and pre-op as well. Usually, hang some Pepcid or Zantac for H[sub:e2ad41996e]2[/sub:e2ad41996e] blockers to help the GI system and especially if they have to go on a vent.

Be sure not to give it too fast, and it has some nasty side effects of acute onset of anger, panic attack, dyskenesia, abdominal pain etc.. read s/e. As other anitemetic be cautious in asthmatics.. etc..

Be safe,

R/R 911

[Just Plain Ruff]

I have extensive experience with Inapsine. This is one of the best drugs out there for nausea.

[antc]

Does anybody have any links to information where Metoclopramide is indicated for these symptoms. We have talked about this for years on the road down here and always believed that it would be more problematic than beneficial. A Dr gave it to patient I had two days ago even though he was unsure if he should. So I'm just after some evidence and or your own experiences.

[Ridryder 911]

I cannot locate where it is contraindicated, although concern if GI bleeding and if bowel obstruction Then again it is used for post surgery abdominal.

Like I stated,we use it routinely for N/V all the time and pre-op, the concern I am sure is for the increase motility and dopa effects. But the dose and amount may not be enough to see changes.

Here is a link with some info for others : http://en.wikipedia.org/wiki/Metoclopramide

Inapsine, although a good antiemetic and pain med, has been under scrutiny the past 5 yrs and is not administered very much due to related cardiac problems and death. Although, I believe this was blown way out of proportion, and the dose that was used was max dose... it still has been tainted and not used very often.

Good luck on our research and Welcome to the City...

R/R 911

[Just Plain Ruff]

I didn't know that about inapsine. It's been a very long time since I've been in the ED where we used it almost exclusively for nausea and vomiting. We NEVER had an issue with Inapsine so it never came up.

thanks for the update.

take care