메토클로프라마이드

동물 종별 용량

투여 경로

금기

• GI hemorrhage
• GI obstruction or perforation
• Hypersensitivity to metoclopramide
• Seizure disorders (relatively contraindicated, lowers seizure threshold)
• Head trauma
• Pheochromocytoma (may induce hypertensive crisis)
• Concurrent phenothiazine therapy
• Dogs with pseudopregnancy (stimulates prolactin release)
• Gastrointestinal obstruction
• Gastrointestinal perforation
• Gastrointestinal hemorrhage
• Seizure disorders (epilepsy)
• Pheochromocytoma

이상반응

• Dogs: Changes in mentation and behavior (motor restlessness, involuntary spasms, aggression, hyperactivity to drowsiness/depression), constipation
• Cats: Frenzied behavior, disorientation, constipation
• Horses: Severe CNS effects (IV use), alternating sedation and excitement, behavioral changes, abdominal pain
• Extrapyramidal effects (tremors, rigid posture)
• Nausea and diarrhea
• Transient hypertension
• Elevated prolactin levels
• Extrapyramidal signs (tremors, twitching, hyperactivity, restlessness)
• Sedation
• Constipation or diarrhea
• Changes in mentation or behavior

약물 상호작용

• Aspirin, Acetaminophen, Alcohol · Metoclopramide may enhance the absorption of these agents.
• Anesthetics · Acute hypotension has been reported if metoclopramide is used concurrently IV.
• Atropine (and anticholinergics) · May antagonize the GI motility effects of metoclopramide.
• Cephalexin · Oral metoclopramide increases cephalexin peak plasma concentrations and AUC in dogs.
• Cholinergic Drugs (e.g., bethanechol) · May enhance metoclopramide's GI effects.
• CNS Depressants · Metoclopramide may enhance CNS depressant effects. · moderate
• Cyclosporine · Metoclopramide increases the rate and extent of GI absorption.
• Opiate Analgesics · May antagonize the GI motility effects and enhance metoclopramide's CNS effects.
• MAO Inhibitors (e.g., amitraz, selegiline) · Could cause hypertension.
• Phenothiazines and Butyrophenones · May potentiate the extrapyramidal effects of metoclopramide.
• Propofol · Reduces induction requirements of propofol by 20-25%.
• SSRI Antidepressants · Potential for enhanced extrapyramidal effects.
• Tetracyclines · Metoclopramide increases the rate and extent of GI absorption.

모니터링

• Clinical efficacy (resolution of vomiting, improved GI transit)
• Adverse effects (especially CNS and extrapyramidal signs)
• Clinical response (reduction in vomiting, improved gastric emptying)
• Hydration status and electrolyte balance
• Signs of extrapyramidal adverse effects (twitching, restlessness)

과용량

The oral LD50 doses are very high (465-870 mg/kg in laboratory animals), making death from oral overdose unlikely in veterinary patients. **Clinical Signs of Toxicity**: * Sedation, ataxia, agitation * Extrapyramidal effects (tremors, rigidity, spasms) * Nausea, vomiting, constipation **Treatment**: * No specific antidote exists. * If ingestion was recent, empty the stomach using standard protocols. * **Anticholinergic agents** that enter the CNS (e.g., **diphenhydramine** at 2.2 mg/kg IV, or benztropine) are highly effective in controlling extrapyramidal effects. * Peritoneal dialysis or hemodialysis is not effective for drug removal.