Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new reglan research articles will be listed here shortly after becoming available to us.
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Medical research on reglan
Am J Hosp Palliat Care. 2008 Jun-Jul; 25(3): 184-9
Kumar G, Hayes KA, Clark R
This is a retrospective analysis of 10 mg metoclopramide, 25 mg diphenhydramine, and 4 mg dexamethasone given intravenous piggyback every 6 hours for nausea or vomiting. Outcome measures were rapidity of symptom relief based on the self-report of the patient and nursing documentation of relief from symptoms of nausea or vomiting. Seven hundred and ninety seven patients were admitted to the inpatient hospice unit during a 2-year period. Sixty-three patients developed nausea or vomiting requiring the cocktail. Fifty-seven patients (90%) had objective response as reflected in nursing notes. Symptom relief was usually noted within 2 days with improvement in oral intake and enjoyment in activities, such as parties and family interactions. Partial relief was noted in patients with gastrointestinal malignancies and peritoneal carcinomatosis even with the addition of other antiemetics to the cocktail.
J AOAC Int. 2008 May-Jun; 91(3): 542-50
El-Enany N
A rapid, simple, and highly sensitive second derivative synchronous fluorometric method has been developed for the simultaneous determination of metoclopramide (MT) and pyridoxine (PY) in a binary mixture. The method is based on measurement of the native fluorescence of these drugs at delta lambda = 80 nm in methanol. The different experimental parameters affecting the native fluorescence of the drugs were carefully studied and optimized. The fluorescence-concentration plots were rectilinear over the ranges of 0.02-0.4 and 0.1-2 microg/mL for MT and PY, respectively. The limits of detection were 0.003 and 0.007 microg/mL and the limits of quantification were 0.008 and 0.02 microg/mL for MT and PY, respectively. The proposed method was successfully applied to the determination of MT and PY in synthetic mixtures and in commercial syrup. The results were in good agreement with those obtained with a reported method. The high sensitivity attained by the proposed method allowed the determination of MT in spiked and real human plasma samples. The mean percent recoveries of MT from spiked and real human plasma (n = 3) were 93.72 +/- 3.15 and 89.72 +/- 2.19 respectively.
Emergency department management of gastro-enteritis in Australia and New Zealand.
J Paediatr Child Health. 2008 Jun 18;
Schutz J, Babl FE, Sheriff N, Borland M,
Objective: Comparison of clinical practice guideline (CPG) recommendations and reported physician management of gastro-enteritis at Paediatric Research in Emergency Departments International Collaborative (PREDICT) network sites as a baseline for further randomised controlled trials. Methods: Two part survey comprising: (i) review of CPGs from PREDICT sites for gastro-enteritis; and (ii) survey of senior emergency department physicians regarding the management of gastro-enteritis. Results: All 11 PREDICT sites participated. Nine CPGs were available with three sites using a common CPG. For moderate dehydration, eight CPGs advocated nasogastric (NG) rehydration in preference to intravenous (IV) rehydration. The IV route was reserved for severe dehydration or failed NG rehydration. In the second component of the survey, 78 of 83 (94%) physicians responded. In moderate dehydration, 82% of respondents used NG rehydration. In severe dehydration, 86% used IV fluids; 12% used NG and 3% an initial IV bolus followed by NG fluid. Serum electrolytes were measured universally with IV fluid use and by 22% using NG rehydration. The IV fluid bolus was with normal saline (86%). Fifty-four per cent used anti-emetics 'rarely' or 'sometimes'. The commonest agents were ondansetron (60%) and metoclopramide (29%). Conclusions: CPG recommendations and physician practice for the management of gastro-enteritis were similar across PREDICT sites with a focus on NG for moderate dehydration and IV for severe dehydration. A variety of fluids and administration rates were used. Anti-emetics were used infrequently. The efficacy and safety of newer anti-emetics should be explored in collaborative studies. Collaborative development of new CPGs should be considered to simplify fluid regimens.
Breastfeed Med. 2008 Jun; 3(2): 120-3
Sakha K, Behbahan AG
BACKGROUND: One of the most common complaints of nursing mothers in a few days after delivery is insufficient lactation. This is known to be partly due to the mothers' deficient knowledge of proper breastfeeding and often results in the beginning of bottlefeeding, which finally diminishes or ceases their breastfeeding. Considering the valuable effects of breastfeeding on nutritional, immunologic, and emotional aspects of infants' health, we planned this study to find out whether training of nursing mothers for breastfeeding can enhance their lactation; also, we tried to compare the effects of metoclopramide on lactation with those of training. METHODS: Throughout 2006, we consecutively enrolled 20 primipara nursing mothers who were referred to Tabriz Children's Hospital, Tabriz, Iran for counseling about prescription of infant formula as a response to their complaint of insufficient lactation during a couple of months after parturition. Only those mothers were included in this study whose newborns had failed to gain appropriate weight, determined by their age and birth weight. First, all newborns were weighed, and all mothers passed a short training course about "perfect practice of breastfeeding"; then we randomly allocated them in two equal groups of 10 mothers-one group received a metoclopramide tablet (10 mg/dose every 8 hours), and the other just placebo, both for a period of 15 days. Thereafter we weighed the newborns again and compared the two recorded weights of each infant and the average weight of the two groups with each other to assess the sufficiency of breastfeeding and effects of training and galactogogue. RESULTS: Eighteen of the 20 newborns studied (90%) showed an appropriate weight gain: 12 newborns gained 385-415 g (mean, 400 +/- 15 g), six neonates gained 270-315 g (mean, 292.5 +/- 22.5 g), but the remaining two newborns gained 150-235 g (mean, 192.5 +/- 42.5 g). Statistical analysis revealed that training of nursing mothers for perfect breastfeeding (with or without metoclopramide consumption) has a significant improving role in infants' weight gain (p < 0.001); however, there was no statistically meaningful difference between the two treatment groups (with and without administration of metoclopramide, p = 0.68). CONCLUSIONS: Counseling nursing mothers for proper lactation before delivery and their continued training thereafter are the main clinical pathways toward a successful and sustained breastfeeding.
Med Monatsschr Pharm. 2008 May; 31(5): 162-70; quiz 171-2
Tamborrini G, Distler M, Distler O
Systemic sclerosis (SSc) is a severe fibrotic multiorgan connective tissue disease. Vascular abnormalities such as fingertip ulcers and Raynaud's syndrome as well as involvement of organs including the lungs, heart, kidney and the gastrointestinal tract are prominent features of the disease. There are currently no disease modifying drugs available that can modify the course of the disease. In this review we will discuss medications that have been found to be effective in improving specific organ involvement due to SSc. For the treatment of gastroesophageal reflux disease (GERD), proton pump inhibitors are effective agents. In the setting of clinically significant gastrointestinal dysmotility, metoclopramide, erythromycin and octreotide may be beneficial. Small bowel bacterial overgrowth should be treated with oral antibiotics. Angiotensin converting enzyme inhibitors are the first-line agents for acute renal crisis. A variety of treatment options are available for Raynaud's phenomenon and include calcium channel blockers, iloprost (i. v.), losartan, fluoxetine and sildenafil. Fingertip ulcers can be prevented by using the endothelin receptor antagonist bosentan. The therapeutic options for treatment of pulmonary hypertension associated with SSc include bosentan, sildenafil and various prostacyclin analogs (eg, epoprostenol, treprostinil, iloprost). Sitaxentan, ambrisentan and new phosphodiesterase-5 inhibitors could be new options for therapy as well. Therapeutic options for interstitial lung fibrosis include cyclophosphamide, however, clinical effects are mild to moderate. Methotrexate has been used to treat skin fibrosis and can be beneficial when arthritis is present.
Comparison of metoclopramide oral tablets and solution in treatment of dysmotility-like dyspepsia.
Am J Health Syst Pharm. 2008 Jun 1; 65(11): 1057-61
Banani SJ, Lankarani KB, Taghavi A, Bagheri MH, Sefidbakht S, Geramizadeh B
PURPOSE: The clinical effects of metoclopramide oral solution and tablets in patients with dysmotility-like dyspepsia (DLD) were compared. METHODS: In a prospective study, 63 patients with DLD, selected according to Rome II criteria and randomly divided into three groups, received metoclopramide tablets 5 mg t.i.d., metoclopramide oral solution 2 mg t.i.d., or placebo for one week. Assessment was based on symptom score determined by interviews and on gastric emptying time measured by ultrasonography before and after drug consumption. Two antral and stomach body biopsies were taken to evaluate infection with Helicobacter pylori and the intensity of gastritis. RESULTS: Symptom score and gastric emptying time were significantly reduced in both metoclopramide groups (p < 0.05) but not in the control group. Patients receiving the oral solution had a greater reduction in the symptom score than those receiving tablets (p < 0.05). The absence or presence of and intensity of gastritis or H. pylori infection had no correlation with the symptom scores or gastric emptying times. CONCLUSION: Metoclopramide oral solution 2 mg t.i.d. was at least as effective as metoclopramide tablets 5 mg t.i.d. in reducing symptoms of DLD and gastric emptying time.
Asian J Surg. 2008 Apr; 31(2): 50-4
Sandhu T, Tanvatcharaphan P, Cheunjongkolkul V
OBJECTIVE: Patients who undergo laparoscopic cholecystectomy may be at risk of experiencing postoperative nausea and vomiting. This prospective, randomized, double-blind study compared the prophylactic use of metoclopramide and ondansetron for the treatment of postoperative nausea and vomiting in patients who underwent elective laparoscopic cholecystectomy. METHODS: Eighty patients were randomized into two groups. Patients received ondansetron 4 mg or metoclopramide 10 mg intravenously in a double-blind manner at the end of anaesthesia. RESULTS: The incidence of nausea was 45% for metoclopramide and 20% for ondansetron in the 24 hours postoperatively; the difference was statistically insignificant (p = 0.05). Postoperative nausea score did not show any significant difference between the two group in the first 2 hours (p = 0.3) and 4 hours (p = 0.12) but was significant between 4 and 24 hours (p = 0.02). The incidence of vomiting was 20% for metoclopramide and 2.5% for ondansetron. This difference was statistically significant (p = 0.02). CONCLUSION: Ondansetron 4 mg given intravenously at the end of surgery is effective for preventing vomiting after laparoscopic cholecystectomy.
Pharm Dev Technol. 2008; 13(3): 233-43
Vora N, Rana V
The purpose of the research was to prepare metoclopramide HCl mouth/orally dissolving tablets (MDTs) using glycine, carboxy methyl cellulose and sodium alginate with sufficient mechanical integrity and disintegration time comparable to superdisintegrants. Application of Plackett-Burman design revealed that concentration of glycine (X(1)), concentration of carboxy methyl cellulose (X(2)) and tablet crushing strength (X(4)) were found to actively influence the dependent variables (disintegration time in oral cavity (DT), wetting time (WT), porosity (P(0)) and water absorption ratio (WA). Additional MDTs were prepared utilizing central composite design for estimating extended effect in a spherical domain. The regression statistics (performed using Statistica(R)-7.0) of quadratic model revealed that DT, WT, P(0) were 97% correlated with active factors (X(1), X(2) or X(4)). The results revealed that optimized MDTs were capable of simulating DT comparable to MDTs containing croscarmellose sodium or crospovidone. Further, it can be envisaged that optimized MDTs were found to be superior to MDTs containing croscarmellose sodium or crospovidone in terms of friability and tablet crushing strength.
Vet Res Commun. 2008 May 15;
El-Khodery SA, Sato M
The aim of the present study was to use of ultrasonography for assessment of reticular motility after administration of various doses of metclopramide and neostigmine in cows. A total of ten Holstein cows were used in six trials in each one single dose of each drug was used. Metoclopramide was used at 0.1, 0.2 and 0.3 mg/kg intramuscularly, whereas neostigmine was used at 0.02, 0.03, and 0.04 mg/kg subcutaneously. Reticular motility was assessed using 3.5 MHz transducer just before drugs administration and every 20 minutes after administration with total time of two hours. At twenty minutes postadministration, metoclopramide at a dose rate of 0.3 mg kg significantly (P < 0.01) produced shortening of the interval time between the two biphasic reticular contractions by 25% and significantly (P < 0.05) increased the amplitude of the first reticular contraction by 42%, but with mild neurological signs. Neostigmine produced non-significant increase in reticular contraction rate and strength. The results of the present study indicate that metoclopramide and neostigmine at selected doses are not clinically useful agents for increasing reticular contraction rate and strength. The findings of this study in healthy animals may not be extrapolatable to findings in cattle with reticuloruminal hypomotility.
Mechanisms for metoclopramide-mediated sensitization and haloperidol-induced catalepsy in rats.
Eur J Pharmacol. 2008 Jun 10; 587(1-3): 181-186
Agovic MS, Yablonsky-Alter E, Lidsky TI, Banerjee SP
Typical antipsychotics such as the dopamine D(2) receptor antagonist, haloperidol are known to cause movement disorders or catalepsy in experimental animals. Catalepsy is believed to result from blockade of dopamine D(2) receptors. In this study two drugs that differ in antipsychotic potency but are similar in blocking dopamine D(2) receptors were used to investigate the mechanism for catalepsy and its sensitization. Metoclopramide is a strong postsynaptic dopamine D(2) receptor blocker with no antipsychotic potency. At low doses of 5 or 10 mg/kg given subcutaneously (s.c.), metoclopramide did not produce catalepsy or movement disturbance for seven days after drug treatment. Also metoclopramide at 10 mg/kg given for five days, failed to induce catalepsy. Haloperidol, another potent dopamine D(2) receptor blocker at 0.5 mg/kg (s.c.) rapidly produced catalepsy and suppressed movement 1 h after a single dose of the drug. Chronic as well as acute treatment with metoclopramide caused sensitization of haloperidol-induced catalepsy. Neurochemical analyses revealed significant dopamine D(2) receptor up-regulation in both frontal cortex and striatum of rats chronically treated with metoclopramide. However, no changes in dopamine D(2) receptor numbers were noted in these areas after chronic treatment with low doses of haloperidol. Significant increases in N-Methyl-d-aspartate (NMDA) receptor numbers were observed in both frontal cortex and striatum of metoclopramide treated animals, while haloperidol elicited significant decreases in NMDA receptor numbers in both brain areas. These observations plus previous reports have led us to propose a model for catalepsy and its sensitization. According to this model the increase in NMDA receptors by metoclopramide sensitizes the brain to haloperidol-induced catalepsy. Thus, catalepsy appears to be elicited by simultaneous activation of glutamatergic NMDA and dopamine D(1) receptors as well as a blockade of dopamine D(2) receptors.