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BMJ Open Oct 2022Hiccup is a common disease that not only occurred on adults but also on infants, which can severely do harm to patients' physical and psychological health....
INTRODUCTION
Hiccup is a common disease that not only occurred on adults but also on infants, which can severely do harm to patients' physical and psychological health. Metoclopramide has been reported to have effects on intractable hiccup. However, there is a limited evidence that describes the efficacy and safety of metoclopramide in the treatment of intractable hiccup. The aim of this article is to obtain evidence on the effectiveness and safety of metoclopramide in treating patients with intractable hiccup.
METHODS AND ANALYSIS
We will search the following databases, including PubMed, Cochrane Library, Embase, Web of Science, CBM, Wan-fang, VIP database, CNKI and MEDLINE from their inception to 11 November 2021. All the randomised controlled trials associated with metoclopramide in treating intractable hiccup will be included. Articles screened, selected and extracted will be performed by two researchers independently. The risk of bias will be assessed by using the Cochrane Collaboration. We will carry out the meta-analysis by using RevMan V.5.4 software.
PROSPERO REGISTRATION NUMBER
CRD42021293000.
Topics: Adult; Data Management; Hiccup; Humans; Meta-Analysis as Topic; Metoclopramide; Research Design; Systematic Reviews as Topic; Treatment Outcome
PubMed: 36202584
DOI: 10.1136/bmjopen-2021-059887 -
BMJ Clinical Evidence Jun 2009More than half of pregnant women suffer from nausea and vomiting, which typically begins by the 4th week and disappears by the 16th week of pregnancy. The cause of... (Review)
Review
INTRODUCTION
More than half of pregnant women suffer from nausea and vomiting, which typically begins by the 4th week and disappears by the 16th week of pregnancy. The cause of nausea and vomiting in pregnancy is unknown, but may be due to the rise in human chorionic gonadotrophin concentration. In 1 in 200 women, the condition progresses to hyperemesis gravidarum, which is characterised by prolonged and severe nausea and vomiting, dehydration, and weight loss.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment for nausea and vomiting in early pregnancy? What are the effects of treatments for hyperemesis gravidarum? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 30 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupressure; acupuncture; antihistamines; corticosteroids; corticotrophins; diazepam; dietary interventions other than ginger; domperidone; ginger; metoclopramide; ondansetron; phenothiazines; and pyridoxine (vitamin B6).
Topics: Acupressure; Administration, Oral; Domperidone; Female; Humans; Metoclopramide; Nausea; Phytotherapy; Pregnancy; Single-Blind Method; United States Food and Drug Administration; Vomiting
PubMed: 21726485
DOI: No ID Found -
Wiener Medizinische Wochenschrift (1946) May 2017The prokinetic cisapride, an important therapeutic option in functional gastrointestinal (GI) disorders, was withdrawn from the market 15 years ago due to rare severe... (Comparative Study)
Comparative Study Review
Modulation of gastrointestinal motility beyond metoclopramide and domperidone : Pharmacological and clinical evidence for phytotherapy in functional gastrointestinal disorders.
The prokinetic cisapride, an important therapeutic option in functional gastrointestinal (GI) disorders, was withdrawn from the market 15 years ago due to rare severe side effects. Likewise in 2014, the use of metoclopramide (MCP) and domperidone in functional GI disorders (FGID) was restricted, consequently leaving a therapeutic gap in clinical practice. A systematic review revealed that the herbal medicinal product (HMP) STW 5 presents a therapeutic option equivalent to MCP and cisapride. STW 5 is the only HMP for which efficacy has been shown in randomized controlled clinical trials (RCTs) in functional dyspepsia and irritable bowel syndrome, based on its multitarget effect on numerous etiological factors. Due to an outstanding favorable safety profile, STW 5 allows an effective and safe use in FGID without a limitation of the duration of the treatment.
Topics: Domperidone; Gastrointestinal Diseases; Gastrointestinal Motility; Humans; Irritable Bowel Syndrome; Metoclopramide; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic
PubMed: 28424994
DOI: 10.1007/s10354-017-0557-3 -
Xenobiotica; the Fate of Foreign... Apr 20141. Metoclopramide is a widely used clinical drug in a variety of medical settings with rare acute dystonic events reported. The aim of this study was to assess a...
1. Metoclopramide is a widely used clinical drug in a variety of medical settings with rare acute dystonic events reported. The aim of this study was to assess a previous report of inactivation of CYP2D6 by metoclopramide, to determine the contribution of various CYPs to metoclopramide metabolism, and to identify the mono-oxygenated products of metoclopramide metabolism. 2. Metoclopramide interacted with CYP2D6 with Type I binding and a Ks value of 9.56 ± 1.09 µM. CYP2D6 was the major metabolizer of metoclopramide and the two major products were N-deethylation of the diethyl amine and N-hydroxylation on the phenyl ring amine. CYPs 1A2, 2C9, 2C19, and 3A4 also metabolized metoclopramide. 3. While reversible inhibition of CYP2D6 was noted, CYP2D6 inactivation by metoclopramide was not observed under conditions of varying concentration or varying time using Supersomes(TM) or pooled human liver microsomes. 4. The major metabolites of metoclopramide were N-hydroxylation and N-deethylation formed most efficiently by CYP2D6 but also formed by all CYPs examined. Also, while metoclopramide is metabolized primarily by CYP2D6, it is not a mechanism-based inactivator of CYP2D6 in vitro.
Topics: Cytochrome P-450 CYP2D6; Cytochrome P-450 CYP2D6 Inhibitors; Dopamine Antagonists; Humans; Hydroxylamine; Hydroxylation; Kinetics; Ligands; Liver; Metoclopramide; Microsomes, Liver; Models, Molecular; Molecular Docking Simulation; Recombinant Proteins
PubMed: 24010633
DOI: 10.3109/00498254.2013.835885 -
Anaesthesia Oct 1979Pseudotetanus is a syndrome which is produced by a variety of non-Clostridial factors. It is usually not difficult to distinguish from tetanus but is must always be...
Pseudotetanus is a syndrome which is produced by a variety of non-Clostridial factors. It is usually not difficult to distinguish from tetanus but is must always be considered in the differential diagnosis. Six cases are reported in which tetanus was considered and in one of them the full treatment for the disease was started. It is hoped that by increasing the awareness of clinicians of this relatively common problem the risk of making an incorrect disagnosis will be reduced.
Topics: Adolescent; Adult; Child; Diagnosis, Differential; Drug Hypersensitivity; Female; Humans; Male; Meningitis, Viral; Metoclopramide; Middle Aged; Muscle Hypertonia; Prochlorperazine; Tetanus
PubMed: 532925
DOI: 10.1111/j.1365-2044.1979.tb08539.x -
Pharmacological Reports : PR 2012Metoclopramide is a centrally acting antiemetic and ketamine is a general anesthetic used with sedatives, tranquilizers and analgesics. Metoclopramide has analgesic...
BACKGROUND
Metoclopramide is a centrally acting antiemetic and ketamine is a general anesthetic used with sedatives, tranquilizers and analgesics. Metoclopramide has analgesic effects and its combination with ketamine causes sedation and hypnosis. The contribution of metoclopramide to the analgesic effect of ketamine is not known. The purpose of the present study was to explore the analgesic effects of metoclopramide and ketamine alone or in combination in mice.
METHODS
The up-and-down method was used to determine the median effective analgesic dosages (ED(50)s) of metoclopramide and ketamine administered intraperitoneally (ip) either alone or concomitantly in male albino Swiss mice. Analgesia was measured by using a hot plate. The ED(50)s of both drugs were analyzed isobolographically to determine the type of interaction between them. The analgesic effect of metoclopramide-ketamine combination (62.3 and 4.3 mg/kg, ip) was also monitored by the hot plate and acetic acid writhing methods.
RESULTS
The analgesic ED(50)s for metoclopramide and ketamine in mice were 30.15 and 2.15 mg/kg, ip, respectively. Concomitant administration of the drugs reduced their ED(50)s to 10.17 and 0.68 mg/kg, ip, respectively. Isobolographic analysis of these ED(50)s for both drugs revealed synergistic analgesic effect. Further, the combination of the drugs was effective analgesic as seen by the hot plate test and by another analgesic test paradigm, the acetic acid-induced writhings in mice.
CONCLUSIONS
The data suggest that the combination of metoclopramide and ketamine synergistically controls acute pain in mice. This combination could be used clinically for restraint and minor surgical interventions in mice.
Topics: Acute Pain; Analgesics; Animals; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Synergism; Drug Therapy, Combination; Injections, Intraperitoneal; Ketamine; Male; Metoclopramide; Mice
PubMed: 22661179
DOI: 10.1016/s1734-1140(12)70768-5 -
American Family Physician Jun 2008Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and... (Review)
Review
Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. The diagnosis of diabetic gastroparesis is made when other causes are excluded and postprandial gastric stasis is confirmed by gastric emptying scintigraphy. Whenever possible, patients should discontinue medications that exacerbate gastric dysmotility; control blood glucose levels; increase the liquid content of their diet; eat smaller meals more often; discontinue the use of tobacco products; and reduce the intake of insoluble dietary fiber, foods high in fat, and alcohol. Prokinetic agents (e.g., metoclopramide, erythromycin) may be helpful in controlling symptoms of gastroparesis. Treatment of diabetes-related constipation and diarrhea is aimed at supportive measures and symptom control. Nonalcoholic fatty liver disease is common in persons who are obese and who have diabetes. In persons with diabetes who have elevated hepatic transaminase levels, it is important to search for other causes of liver disease, including hepatitis and hemochromatosis. Gradual weight loss, control of blood glucose levels, and use of medications (e.g., pioglitazone, metformin) may normalize hepatic transaminase levels, but the clinical benefit of aggressively treating nonalcoholic fatty liver disease is unknown. Controlling blood glucose levels is important for managing most gastrointestinal complications.
Topics: Algorithms; Antiemetics; Diabetes Complications; Fatty Liver; Gastric Emptying; Gastroparesis; Humans; Metoclopramide
PubMed: 18619079
DOI: No ID Found -
Cancer Control : Journal of the Moffitt... Apr 2012Chemotherapy-induced nausea and vomiting (CINV) is one of the most debilitating toxicities associated with cancer treatment. Although effective antiemetic agents are... (Review)
Review
BACKGROUND
Chemotherapy-induced nausea and vomiting (CINV) is one of the most debilitating toxicities associated with cancer treatment. Although effective antiemetic agents are available, their use in practice often is suboptimal.
METHODS
The author reviews the pathophysiology of CINV as well as the drug classes and cost considerations that should be incorporated into treatment planning.
RESULTS
Several drug classes, including 5-hydroxytryptamine-3 receptor antagonists, neurokinin-1 receptor antagonists, and corticosteroids, are effective, especially when used in combination. Older antiemetic agents, such as prochlorperazine and metoclopramide, as well as olanzapine may provide reasonable alternatives in certain settings.
CONCLUSIONS
Interventions for CINV should include standard-of-care antiemetics combined with corticosteroids. The cost of using older, less expensive antiemetics may be outweighed by the expenditures to rescue patients after suboptimal prophylaxis, as well as the indirect costs of missed work and lost productivity.
Topics: Antiemetics; Antineoplastic Agents; Humans; Metoclopramide; Nausea; Prochlorperazine; Vomiting
PubMed: 22488022
DOI: 10.1177/107327481201902s02 -
Journal of Clinical Gastroenterology Jul 2012
Topics: Dopamine Antagonists; Female; Gastroparesis; Humans; Male; Metoclopramide; Polymorphism, Single Nucleotide
PubMed: 22688139
DOI: 10.1097/MCG.0b013e3182549528 -
Acta Medica Iranica Apr 2017Postoperative nausea and vomiting (PONV) are one of the most common complications of anesthesia and without prophylactic intervention occurs by about one-third of... (Comparative Study)
Comparative Study Randomized Controlled Trial
Postoperative nausea and vomiting (PONV) are one of the most common complications of anesthesia and without prophylactic intervention occurs by about one-third of patients under general anesthesia. The aim of this study was to compare the efficacy of ondansetron and metoclopramide in reducing PONV after laparoscopic cholecystectomy. In this study, 60 patients undergoing laparoscopic cholecystectomy were randomly allocated into two equal groups (n=30), and in the first group 10 mg metoclopramide and in the second group 4 mg ondansetron preoperatively were injected. Nausea and vomiting and the need for rescue antiemetic treatment in recovery and 6 hr. and 6-24 hrs. After surgery were evaluated. Data were analyzed by SPSS software with chi-square test and analysis of variance (ANOVA). The incidence of nausea in metoclopramide was 43.3 % and in ondansetron was 33.3 %. The difference between two groups was not significant (P=0.6). The incidence of vomiting in metoclopramide was 20% and in ondansetron was 26.7%, and there was not any significant difference between intervention groups (P=0.12). For prevention of PONV after laparoscopic cholecystectomy, both metoclopramide and ondansetron are effective, and in preventing of nausea, ondansetron is more effective than metoclopramide, whereas there was not any significant difference between two drugs in preventing of vomiting.
Topics: Adult; Analysis of Variance; Anesthesia, General; Antiemetics; Cholecystectomy, Laparoscopic; Double-Blind Method; Female; Humans; Incidence; Male; Metoclopramide; Middle Aged; Ondansetron; Postoperative Nausea and Vomiting
PubMed: 28532137
DOI: No ID Found