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General and Comparative Endocrinology Aug 2013In this work we have evaluated the gene expression profile of prolactin and prolactin receptor in the pituitary and the uterus of female mice with metoclopramide-induced...
UNLABELLED
In this work we have evaluated the gene expression profile of prolactin and prolactin receptor in the pituitary and the uterus of female mice with metoclopramide-induced hyperprolactinemia treated with estrogen and/or progesterone. For this purpose, 49 Swiss female mice were allocated to seven groups.
INTERVENTIONS
50-day treatment with metoclopramide, progesterone and estrogen. Our results showed that in the pituitary, metoclopramide-induced hyperprolactinemia increased prolactin expression. In the castrated animals, progesterone, with or without estrogen, produced an increase in prolactin. Pituitary prolactin receptor and the estrogen and progesterone treatment were responsible for the rise in PRLR-S2. In the uterus, no differences in prolactin expression were found between the different study groups. PRLR-S1 had its expression reduced in all castrated animals as against the castrated group treated with vehicle. In the noncastrated animals, PRLR-S2 rose in the metoclopramide-treated group, and, in the castrated animals, its expression diminished in all groups in relation to the vehicle-treated castrated controls. An increase in PRLR-S3 was found in the oophorectomized animals treated with a combination of estrogen and progesterone. PRLR-L rose in the oophorectomized animals treated with progesterone in isolation or in association with estrogen. These findings suggest that metoclopramide associated to progesterone or estrogen may determine an increase in pituitary prolactin and PRLR-S2 expression. The estrogen-progesterone may enhance the expression of PRLR-S3 and PRLR-L isoform of prolactin receptor.
Topics: Animals; Estrogens; Female; Hyperprolactinemia; Metoclopramide; Mice; Pituitary Gland; Progesterone; Receptors, Prolactin; Uterus
PubMed: 23684968
DOI: 10.1016/j.ygcen.2013.04.037 -
The Cochrane Database of Systematic... Sep 2011Vomiting is a common manifestation of acute gastroenteritis in children and adolescents. When untreated it can be a hindrance to oral rehydration therapy, which is the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Vomiting is a common manifestation of acute gastroenteritis in children and adolescents. When untreated it can be a hindrance to oral rehydration therapy, which is the cornerstone in the management of acute gastroenteritis. Evidence is needed concerning the safety and efficacy of antiemetic use for vomiting in acute gastroenteritis in children.
OBJECTIVES
To assess the safety and effectiveness of antiemetics on gastroenteritis induced vomiting in children and adolescents.
SEARCH STRATEGY
We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register comprising references identified from comprehensive electronic database searches and hand searches of relevant journals and abstract books of conferences.The search was re-run and is up to date as on 20 July 2010.
SELECTION CRITERIA
Randomized controlled trials comparing antiemetics with placebo or no treatment, in children and adolescents under the age of 18, for vomiting due to gastroenteritis.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trial quality and extracted data.
MAIN RESULTS
We included seven trials involving 1,020 participants. Mean time to cessation of vomiting in one study was 0.34 days less with dimenhydrinate suppository compared to placebo (P value = 0.036). Pooled data from three studies comparing oral ondansetron with placebo showed: a reduction in the immediate hospital admission rate (RR 0.40, NNT 17, 95% CI 10 to 100) but no difference between the hospitalization rates at 72 hours after discharge from the Emergency Department (ED); a reduction in IV rehydration rates both during the ED stay (RR 0.41, NNT 5, 95% CI 4 to 8), and in follow-up to 72 hours after discharge from the ED stay (worst-best scenario for ondansetron RR 0.57, NNT 6, 95% CI 4 to 13) and an increase in the proportion of patients with cessation of vomiting (RR 1.34, NNT 5, 95% CI 3 to 7)). No significant difference was noted in the revisit rates or adverse events, although diarrhea was reported as a side effect in four of the five ondansetron studies. In one study the proportion of patients with cessation of vomiting in 24 hours was (58%) with IV ondansetron, (17%) placebo and (33%) in the metoclopramide group (P value = 0.039).
AUTHORS' CONCLUSIONS
Oral ondansetron increased the proportion of patients who had ceased vomiting and reduced the number needing intravenous rehydration and immediate hospital admission. Intravenous ondansetron and metoclopramide reduced the number of episodes of vomiting and hospital admission, and dimenhydrinate as a suppository reduced the duration of vomiting.
Topics: Acute Disease; Adolescent; Antiemetics; Child; Child, Preschool; Fluid Therapy; Gastroenteritis; Hospitalization; Humans; Metoclopramide; Ondansetron; Randomized Controlled Trials as Topic; Vomiting
PubMed: 21901699
DOI: 10.1002/14651858.CD005506.pub5 -
Paediatric Drugs Aug 2015Metoclopramide is the only medication widely used to promote gastrointestinal motility in the USA. Despite its appreciable risk of central nervous system complications,...
OBJECTIVE
Metoclopramide is the only medication widely used to promote gastrointestinal motility in the USA. Despite its appreciable risk of central nervous system complications, it continues to be prescribed to children for chronic use. We sought to estimate the prevalence of chronic metoclopramide use among US children and identify the diagnoses that may have prompted this use. The US metoclopramide label lists only two indications in adults: symptomatic gastroesophageal reflux (GERD) and diabetic gastroparesis. The latter is rare in children so, in examining the indications likely to have prompted chronic metoclopramide use, we focused on GERD.
METHODS
From two health services databases representing privately and publically insured children, respectively, we estimated the number of US children who used metoclopramide chronically and identified the diagnoses recorded at approximately the time when the chronic use began. We defined chronic use liberally as ≥ 35 days' supply, or conservatively as ≥ 130 days' supply in a 6-month period. For each chronic-use definition, insurance type, and age group, we estimated the proportion of children using metoclopramide chronically. We applied these proportions to US population estimates.
RESULTS
Under the liberal and conservative definitions, respectively, 89,020 and 28,222 US children used metoclopramide chronically.
CONCLUSION
In spite of its risk, substantial numbers of US children use metoclopramide chronically for symptoms suggestive of GERD.
Topics: Child; Gastroesophageal Reflux; Humans; Metoclopramide; Pediatrics; Prevalence; United States
PubMed: 26014368
DOI: 10.1007/s40272-015-0136-2 -
Anaesthesia Jul 1997In a randomised, double-blind study, we have compared the incidence of postoperative nausea and vomitting in 124 patients undergoing major lower limb orthopaedic surgery... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
In a randomised, double-blind study, we have compared the incidence of postoperative nausea and vomitting in 124 patients undergoing major lower limb orthopaedic surgery following oral premedication with temazapam and ondansetron 8 mg, metoclopramide 10 mg or placebo. They received a standardised epidural and general anaesthetic. An epidural mixture containing bupivacaine 0.1% and fentanyl 10 mg.ml-1 was infused postoperatively. The occurrence of nausea and vomiting was assessed every 4 h for 24 h. The incidence of vomiting significantly decreased from 55% and 43% in the placebo and metoclopramide groups, respectively, to 26% in the ondansetron group (p = 0.03). The incidence of nausea and vomiting in patients who had previously suffered was also significantly reduced from 67% and 68% in the placebo and metoclopramide groups, respectively, to 29% in the ondansetron group (p = 0.035). We conclude that oral premedication with ondansetron 8 mg was superior to metoclopramide 10 mg and placebo in preventing postoperative nausea and vomiting following major orthopaedic surgery in patients given epidural opioid analgesia.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antiemetics; Double-Blind Method; Female; Humans; Male; Metoclopramide; Middle Aged; Nausea; Ondansetron; Postoperative Complications; Premedication; Vomiting
PubMed: 9244032
DOI: 10.1111/j.1365-2044.1997.az0130a.x -
Medicine Sep 2019In this study, we will assess the efficacy and safety of metoclopramide for the treatment of acute migraine (AM).
BACKGROUND
In this study, we will assess the efficacy and safety of metoclopramide for the treatment of acute migraine (AM).
METHODS
We will comprehensively search Cochrane Library, PUMBED, EMBASE, Google Scholar, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from the inception to July 1, 2019 to identify any eligible studies. Only randomized controlled trials will be considered for inclusion. The study selection, data collection, and management will be completed by two authors independently. The risk of bias will be assessed using Cochrane risk of bias tool. RevMan 5.3 software will be used for statistical analysis.
RESULTS
The primary outcome includes pain intensity, as measured by visual analogue scale or others. The secondary outcomes are success rate, requirement of rescue medicine, quality of life, relapse, and adverse events.
CONCLUSIONS
This study will summarize the latest evidence for the clinical efficacy and safety of metoclopramide for the treatment of AM.
PROSPERO REGISTRATION NUMBER
PROSPERO CRD42019142795.
Topics: Analgesics; Humans; Meta-Analysis as Topic; Metoclopramide; Migraine Disorders; Randomized Controlled Trials as Topic; Systematic Reviews as Topic
PubMed: 31517828
DOI: 10.1097/MD.0000000000017065 -
Journal of Neurology, Neurosurgery, and... Apr 1975Metoclopramide is an antiemetic drug which occasionally produced acute dystonic reactions. Although known to interfere with central dopamine mechanisms, it is frequently... (Clinical Trial)
Clinical Trial Comparative Study
Metoclopramide is an antiemetic drug which occasionally produced acute dystonic reactions. Although known to interfere with central dopamine mechanisms, it is frequently used in Parkinson's disease to prevent levodopa-induced nausea and vomiting. In this study metoclopramide did not increase Parkinsonism or reduce levodopa-induced involuntary movements in patients with Parkinson's disease. Pimozide, by contrast, increased Parkinsonism and reduced involuntary movements. The capacity of metoclopramide to produce acute dyskinesias while being apparently free of Parkinsonism effects is pharmacologically unique and differentiates this drug from the phenothiazines and butyrophenones.
Topics: Aged; Carbidopa; Clinical Trials as Topic; Drug Evaluation; Drug Interactions; Drug Therapy, Combination; Female; Humans; Levodopa; Male; Metoclopramide; Middle Aged; Movement Disorders; Nausea; Parkinson Disease; Parkinson Disease, Secondary; Pimozide; Placebos; Promethazine
PubMed: 1095689
DOI: 10.1136/jnnp.38.4.331 -
Alimentary Pharmacology & Therapeutics Dec 2007Gastroparesis is a disorder characterized by a delay in gastric emptying of a meal in the absence of a mechanical gastric outlet obstruction. (Review)
Review
BACKGROUND
Gastroparesis is a disorder characterized by a delay in gastric emptying of a meal in the absence of a mechanical gastric outlet obstruction.
AIM
To provide an evidence based overview on diagnosis and management of gastroparesis.
METHODS
A PubMed search was performed using search terms including gastroparesis, gastric retention, gastric emptying, accommodation, manometry, prokinetics, antiemetics, metoclopramide, domperidone, erythromycin, botulinum toxin, gastric pacing. Relevant studies were identified and original articles and reviews were collected. References in these articles were examined for relevance and included where appropriate.
RESULTS
Diagnosis of gastroparesis is based on the presence of symptoms such as nausea, vomiting and postprandial abdominal fullness and on an objectively determined delay in gastric emptying. The true prevalence of gastroparesis is unknown. Gastric emptying can be assessed by scintigraphy and stable isotope breath tests. Management of gastroparesis consists of dietary and lifestyle measures and/or pharmacological interventions (prokinetics, antiemetics, intrapyloric botulinum toxin injection) or other interventions that focus on adequate nutrient intake either through a nasoduodenal tube, percutaneous gastrostomy or jejunostomy.
CONCLUSIONS
Accurate diagnosis of gastroparesis requires an adequate protocol to measure gastric emptying. Treatment options in gastroparesis remain limited despite the disabling nature of the disorder.
Topics: Diet; Domperidone; Dopamine Antagonists; Erythromycin; Gastric Emptying; Gastrointestinal Agents; Gastroparesis; Humans; Life Style; Metoclopramide; Treatment Outcome
PubMed: 18081647
DOI: 10.1111/j.1365-2036.2007.03534.x -
The Canadian Veterinary Journal = La... Feb 1995
Review
Topics: Animals; Cisapride; Gastrointestinal Motility; Humans; Metoclopramide; Piperidines; Sympathomimetics
PubMed: 7728729
DOI: No ID Found -
Danish Medical Journal Jul 2014Breast milk has many advantages over formula for infants in developed and developing countries alike. Despite intentions of breastfeeding, some women develop...
INTRODUCTION
Breast milk has many advantages over formula for infants in developed and developing countries alike. Despite intentions of breastfeeding, some women develop insufficient lactation. Treatment options traditionally include breastfeeding education and pharmacotherapy.
MATERIAL AND METHODS
An electronic questionnaire regarding treatment of insufficient lactation was sent to all obstetric departments (n = 21) and neonatal wards (n = 17) in Denmark. Three main questions were included which focused on: breastfeeding education for women, use of pharmacotherapy and availability of local guidelines.
RESULTS
In all, 30 out of a total of 38 departments participated; and among those, 93% offered some form of breastfeeding education. 50% used either metoclopramide or syntocinon to promote lactation. None used domperidone. 73% had a local clinical guideline. 77% offered sessions with a lactation consultant.
CONCLUSION
Despite lack of evidence, half of the Danish obstetric departments and neonatal wards use metoclopramide and syntocinon for insufficient lactation. Domperidone might provide an alternative, but no departments reported its use. Management of insufficient lactation should always be initiated by counselling and education. Only when these treatment options are exhausted should pharmacotherapy with a suitable medication be considered.
Topics: Breast Feeding; Denmark; Dopamine D2 Receptor Antagonists; Evidence-Based Medicine; Female; Humans; Lactation Disorders; Metoclopramide; Neonatology; Obstetrics; Oxytocics; Oxytocin; Patient Education as Topic; Practice Guidelines as Topic; Surveys and Questionnaires
PubMed: 25123119
DOI: No ID Found -
BMC Gastroenterology Oct 2023Since the previous network meta-analysis assessing the efficacy of prokinetics for functional dyspepsia (FD), there have been a number of new studies and cinitapride is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Since the previous network meta-analysis assessing the efficacy of prokinetics for functional dyspepsia (FD), there have been a number of new studies and cinitapride is a new prokinetic agent for FD. This updated meta-analysis aimed to explore the efficacy and safety of prokinetics for FD.
METHODS
An updated study search in Pubmed, EMBASE, Cochrane Library and Web of Science was conducted in literatures published from July 2015 to March 2023. Randomized controlled trials investigating the use of prokinetics in adult FD patients were included. The primary outcome was the total efficacy rate and the secondary outcome was adverse events. A Bayesian network meta-analysis was performed using R software.
RESULTS
A total of 28 studies were included. Network meta-analysis showed that metoclopramide had a higher total efficacy rate than mosapride (OR: 3.53, 95%CI: 1.70-7.47), domperidone (OR: 2.29, 95%CI: 1.16-4.63), itopride(OR: 2.77, 95%CI: 1.41-5.59), acotiamide(OR: 2.63, OR: 1.33-5.36), and placebo(OR: 5.68, 95%CI: 2.98-11.10), however similar to cinitapride (OR: 1.62, 95%CI: 0.75-3.53). Cinitapride had a higher total efficacy rate than mosapride (OR: 2.18, 95%CI: 1.16-4.14) and placebo (OR: 3.52, 95%CI: 2.01-6.24). Cinitapride had lower risk of total adverse events than domperidone. There was no difference in the risk of drug-related adverse events between the prokinetics.
CONCLUSIONS
Metoclopramide and cinitapride may have a better efficacy than other prokinetics in the treatment of FD, and cinitapride may have a lower risk of total adverse events. Further studies using uniform definitions or validated tools to measure the total efficacy rate are needed.
Topics: Adult; Humans; Dyspepsia; Domperidone; Metoclopramide; Network Meta-Analysis; Bayes Theorem; Randomized Controlled Trials as Topic
PubMed: 37907846
DOI: 10.1186/s12876-023-03014-9