your patient with parkinson’s disease is taking metoclopramide for GERD.?
Thursday, October 15th, 2009 at
7:26 am
Which statement is false.
a. the frequency of this metoclopramide causing extrapyramidal symptoms and depressions is highest in those with history of mental illness, children ans older adults.
b. this medication may cause drowsiness, confusion or depression
c. This medication is first line treatment for GERD.
d. this drug should be used with great caution in persons with Parkinson’s Disease as it blocks dopamine receptors and may worsen symptoms of PD.
Filed under: Gerd Treatments
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c. Dopamine antagonists are seldom used for Parkinson’s disease any longer. They are used as anti-psychotics for PD primarily. They most certainly wouldn’t be a first line medication for GERD in a PD patient.
That said there might be some benefit to the action of metoclopramide in the case of the common digestive issues of PD as it does increase muscle contraction of the upper GI tract.
a) is true
b) is also a precautionary warning
d) is another warning about dopamine antagonists which bind to the dopamine receptors but do not stimulate them. Because the PD medication (drug interactions) of this patient is unknown in the question, the statemtment is also true.
Take a look at this abstract to see if it provides additional insight into the correct answer.
http://www3.interscience.wiley.com/journal/118506024/abstract?CRETRY=1&SRETRY=0
While there might be a reason for prescribing it, it would never be a first line treatment for a PD patient as defined in the question.
Dopamine antagonists cause Parkinsonian-like symptoms. The correct answer is D.
http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/017854s052,021793s005medguide.pdf
D. for sure this drug surely worsens symptoms of anything you have. I was prescribed metoclopramide for digesting food faster but instead I had a dystonic reaction which included uncontrolled muscle movements in tongue and jaw. Worst feeling you could ever imagine I was so frightened. I couldn’t even talk so I had go to ER and was given an injection of Benadryl to relax and cure it. I know for sure I won’t be even using this drug anymore.