Meds card : Metoclopramide (메토클로프라미드) (Eng/Kor) for NCLEX

Metoclopramide (메토클로프라미드)

Classification / 분류

English: Antiemetic, prokinetic agent
Korean: 항구토제, 위장운동촉진제

Mechanism of Action / 작용 기전

English:

• Dopamine (D2) receptor antagonist → reduces nausea/vomiting
• Increases GI motility by enhancing acetylcholine in the GI tract
• Promotes gastric emptying and intestinal movement

Korean:

• 도파민(D2) 수용체 차단 → 구역·구토 감소
• 장운동 촉진 (아세틸콜린 활성 증가)
• 위 배출 촉진, 장운동 증가

 

 

 

 

 

 

 

 

Indications / 적응증

English:

• Nausea and vomiting
• GERD (increases gastric emptying)
• Diabetic gastroparesis
• Prevention of nausea from chemo/anesthesia

Korean:

• 구역, 구토
• 위식도역류(위 배출 촉진)
• 당뇨병성 위마비
• 항암제/마취 후 구토 예방

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Side Effects / 부작용

Common:

• Drowsiness / 졸림
• Fatigue / 피로
• Diarrhea / 설사
• Restlessness / 불안

Serious:

• Extrapyramidal symptoms (EPS) / 추체외로 증상
  • dystonia, akathisia, parkinsonism
• Tardive dyskinesia (long-term use) / 지연성 운동장애
• Neuroleptic malignant syndrome (rare) / 신경이완 악성증후군
• Depression, suicidal thoughts (rare) / 우울, 자살 충동

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nursing Considerations / 간호 시 고려사항

• Assess for EPS symptoms
• Use for short term only (avoid long-term due to tardive dyskinesia risk)
• Avoid in patients with bowel obstruction
• Avoid with antipsychotics (EPS risk ↑)
• Monitor sedation level
• Give 30 minutes before meals and at bedtime

Korean:

• 추체외로 증상(EPS) 관찰
• 장기 사용 금지 (지연성 운동장애 위험)
• 장폐색 환자 금기
• 항정신병 약물과 병용주의
• 진정 여부 모니터
• 식전 30분, 취침 전 투여

Contraindications / 금기

• GI obstruction, perforation / 장폐색, 천공
• Seizure disorder / 발작 병력
• Pheochromocytoma / 갈색세포종
• Parkinson’s disease (worsens symptoms) / 파킨슨 악화

Brand Names / 상품명

• Reglan
• Maxeran (Canada)

 

Duration / 약효 시간

1. PO (Oral / 경구)

• Onset (작용 시작): 30–60 min
• Peak (최고 농도): 1–2 hr
• Duration (지속 시간): 3–6 hr

2. IV (Intravenous / 정맥 투여)

• Onset: 1–3 min
• Peak: 5–15 min
• Duration: 1–2 hr

3. IM (Intramuscular / 근육 주사)

• Onset: 10–15 min
• Peak: 1–2 hr
• Duration: 1–2 hr

 Quick English–Korean Summary Table

Route / 투여 경로Onset 작용 시작Peak 최고Duration 지속

PO (경구)	30–60 min	1–2 hr	3–6 hr
IV (정맥)	1–3 min	5–15 min	1–2 hr
IM (근육)	10–15 min	1–2 hr	1–2 hr

 

 

 

 

Adverse / Serious Side Effects

(메토클로프라미드 – 주요 부작용)

**1. Extrapyramidal Symptoms (EPS)

추체외로 증상**

• Acute dystonia (muscle spasms) / 급성 근육경련
• Akathisia (restlessness) / 좌불안석증
• Parkinsonism (rigidity, tremor) / 파킨슨 증상(경직, 떨림)

**2. Tardive Dyskinesia (TD)

지연성 운동장애 (가장 위험!)**

• Involuntary movements of face, tongue, lips
• Lip smacking, tongue protrusion
• Often irreversible

Korean:

• 얼굴·혀·입 주변의 비자발적 움직임
• 입핥기, 혀 내밀기
• 비가역적일 수 있음

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

**3. Neuroleptic Malignant Syndrome (NMS)

신경이완 악성 증후군 (희귀하지만 치명적)**

• High fever / 고열
• Muscle rigidity / 근육 강직
• Autonomic instability (HR ↑, BP 변화) / 자율신경 불안정
• Mental status change / 의식 변화

**4. Depression & Suicidal Thoughts

우울 및 자살 충동**

• Mood changes / 기분 변화
• Increased depression / 악화된 우울감

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

**5. Endocrine Side Effects

내분비 부작용 (Prolactin ↑)**

• Galactorrhea (milk discharge) / 유즙 분비
• Gynecomastia / 여성형 유방
• Menstrual irregularities / 생리 불규칙

**6. Cardiovascular Effects

심혈관 부작용**

• Hypertension or hypotension / 고혈압 또는 저혈압
• Tachycardia / 빈맥
• Fluid retention (rare) / 체액 저류

 

 

 

 

 

 

 

 

 

 

 

 

 

**7. GI Side Effects (Paradoxical)

위장 부작용**

• Severe diarrhea / 심한 설사
• Abdominal cramps / 복통

**8. Allergic Reactions

알레르기 반응**

• Rash / 발진
• Hives / 두드러기
• Anaphylaxis (rare) / 아나필락시스

 Quick Memory Tip

“EPS, TD, NMS → Big 3 dangerous side effects.”
“TD = irreversible → avoid long-term use.”

Korean:
“EPS, TD, NMS = 메토클로프라미드의 3대 위험 부작용.”
“TD는 비가역 → 장기 사용 금지.”

 

 

 

 

Assessment Before Administering Metoclopramide

(투여 전 필수 사정)

1. Neurological Assessment (EPS risk)

Check for any existing extrapyramidal symptoms, because metoclopramide can worsen them.

• Tremors
• Muscle rigidity
• Facial spasms
• Restlessness / Akathisia
• Abnormal movements

If present → HOLD the medication and notify provider.

2. GI Assessment

Metoclopramide is contraindicated in mechanical GI problems.

Assess for signs of:

• Bowel obstruction (no bowel sounds, severe distention, vomiting)
• GI perforation (rigid abdomen, severe sudden pain)
• GI bleeding (coffee-ground emesis, melena)

If suspected → DO NOT give.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Abdomen Assessment

• Bowel sounds (present? hypoactive? absent?)
• Abdominal distention
• Abdominal pain characteristics
• N/V severity

4. Vital Signs

Pay attention to:

• BP (risk of hypotension)
• HR
• Temperature (high fever may indicate NMS risk)

5. Mental Status / Baseline Neuro

Because metoclopramide can cause:

• Sedation
• Confusion
• Depression
• Suicidal ideation (rare)

Assess baseline:

• LOC
• Orientation
• Mood/behavior

 

 

 

 

 

 

 

 

 

 

 

6. Renal Function (Kidney Clearance)

Metoclopramide is renally cleared → ↑ toxicity if renal impairment.

Check labs:

• Creatinine
• BUN

If renal impairment → dose may need reduction.

7. Pregnancy & Breastfeeding Status

• Safe in pregnancy category B, but confirm
• Crosses breast milk → assess if breastfeeding

8. Drug Interactions

Check for meds that increase side effects:

• Antipsychotics → ↑ EPS
• Opioids → ↑ sedation
• CNS depressants → ↑ respiratory depression
• MAOIs → hypertension crisis risk

9. Timing / Administration Considerations

• Give 30 minutes before meals
• Give at bedtime if ordered
• Ensure patient can swallow or appropriate IV access is verified