Effects of metoclopramide on gastric motility measured by short-term bio-impedance

AIM:To analyze the accuracy of short-term bio-impedance as a means of measuring gastric motility.METHODS: We evaluated differences in the short-term electrical bio-impedance signal from the gastric region in the following conditions: (1) fasting state, (2) after the administration of metoclopramide (a drug that induces an increase in gastric motility) and (3) after food ingestion in 23 healthy volunteers. We record-ed the real component of the electrical impedance signal from the gastric region for 1000 s. We performed a Fast Fourier Transform (FFT) on this data and then compared the signal among the fasting, medicated, and postprandial conditions using the median of the area under the curve, the relative area under the curve and the main peak activity.RESULTS: The median of the area under the curve of the frequency range in the region between 2-8 cycles per minute (cpm) decreased from 4.7 cpm in the fasting condition to 4.0 cpm in the medicated state (t=3.32, P=0.004). This concurred with the decrease seen in the relative area under the FFT curve in the region from 4 to 8 cpm from 38.3% to 26.6% (t=2.81, P=0.012) and the increase in area in the region from 2 to 4 cpm from 22.4% to 27.7%, respectively (t=-2.5, P=0.022). Finally the main peak position also decreased in the region from 2 to 8 cpm. Main peak activity in the fasting state was 4.72 cpm and declined to 3.45 cpm in the medicated state (t=2.47, P=0.025). There was a decrease from the fasting state to the postprandial state at 3.02 cpm (t=4.0, P=0.0013). CONCLUSION: Short-term electrical bio-impedance can assess gastric motility changes in individuals experiencing gastric stress by analyzing the area medians and relative areas under the FFT curve.

Pain reduction and adverse effects of intravenous metoclopramide for acute migraine attack: A systematic review and meta-analysis of randomized-controlled trials

BACKGROUND Metoclopramide may be used to treat people suffering from acute migraine.However,no comprehensive investigation on this issue has been recorded.This review will provide more solid evidence for the use of metoclopramide in treating acute migraine.AIM To compare the efficacy of intravenous metoclopramide with other therapies in migraine attack treatment in an emergency department(ED).METHODS We included randomized controlled trials of participants older than 18 years with acute migraine headaches,which included at least one arm that received intravenous(IV)metoclopramide at the ED.A literature search of PubMed,Web of Science,Cochrane Collaboration,and Reference Citation Analysis on December 31,2021 retrieved other drugs or placebo-controlled studies without language limitation.The risk of bias was assessed using the Cochrane risk of bias tool.The primary endpoint was pain reduction at 60 min or closest to 1 h after treatment,as measured by the pain scale.Secondary endpoints included adverse effects or reactions resulting from metoclopramide or comparisons.RESULTS Fourteen trials with a total of 1661 individuals were eligible for review.The risk of bias ranged from low to intermediate.IV metoclopramide administration was not associated with higher pain reduction at 1 h(Standard mean difference[SMD]=-0.03,95%confidence interval[CI]:-0.33-0.28,P=0.87).However,metoclopramide was associated with better pain reduction than placebo(SMD=1.04,95%CI:0.50-1.58,P=0.0002).In addition,side effects were not significantly different between IV metoclopramide and other drugs or placebo(odds ratio[OR]=0.76,95%CI:0.48-1.19,P=0.09 and OR=0.92,95%CI:0.31-2.74,P=0.54,respectively).CONCLUSION Metoclopramide is more effective than placebo in treating migraine in the ED.Despite the observed tendency of decreased side effects,its effectiveness compared to other regimens is poorly understood.More research on this area is needed to treat migraine in acute care settings effectively.

Effects of metoclopramide on gastrointestinal myoelectric activity in rats

AIM To investigate the differences of metoclopramide (MCP) action on myoelectric activity of antrum and small intestine. METHODS Ten healthy male Wistar rats, weighing 250g～350g, were anesthetized with ketamine hydrochloride (100mg/kg, intramuscularly). Four pairs of bipolar stainless steel electrodes 3mm apart were implanted on serosal surface of antrum and 1, 10 and 20cm distal to pylorus respectively. Five to 10 days after operation, the gastrointestinal myoelectric activity of fasted rats after intramuscular injection of 2 5, 6 and 12mg/kg MCP respectively ws recorded with a 8 channel EEG machine, and was quantitatively compared with the myoelectric activity after saline injection. RESULTS In fasted rats, 2 5mg/kg MCP increased the amplitude of spike activity (402 0μV±138 4μV, vs 345 0μV±163 4μV, P <0 05) and the percentage of the slow wave containing spike bursts (60 4%±22 0% vs 47 4%±22 5%, P <0 01) of small intestine (1cm distal to pylorus), but did not affect the myoelectric activity of antrum. Six and 12mg/kg MCP increased the amplitude of both the slow wave (332 8μV±200 1μV vs 191 2μV±143 9μV, P <0 01; 330 0μV±197 1μV vs 191 2μV±143 9μV, P <0 05) and the spike activity (180 5μV±69 7μV vs 121 8μV±63 3μV, P <0 05; 174 5μV±71 7μV vs 123 8μV±63 3μV, P <0 05) of antrum, while in small intestine (1cm distal to pylorus) only that of the amplitude of spike activity (407 3μV±179 0μV vs 345 0μV±163 4μV, P <0 05; 456 0μV±145 4μV vs 345 0μV±163 4μV, P <0 05) and the percentage of the slow wave containing spike bursts (61 7%±26 5% vs 47 4%±22 5%, P <0 01; 59 1%±17 3% vs 47 4%±22 5%, P <0 01) was increased and with latent period significantly prolonged (2 5min±0 35min vs 0 77min±0 18min, P <0 01). CONCLUSION Different mechanisms may be involved in increasing the myoelectric activity of antrum and small intestine after MCP administration.

Electrogenerated chemiluminescence sensor for the determination of metoclopramide using ordered mesoporous carbon for immobilizing tris(2,2'-bipyridyl)ruthenium

A novel electrogenerated chemiluminescence(ECL)sensor for the determination of metoclopramide was developed by employing ruthenium complex as an ECL signal producer and an ordered mesoporous carbon(OMC)material as modified material.The ECL sensor was fabricated by adsorption ruthenium complex into a mixture of OMC and Nafion,which showed good electrochemical and ECL behaviors.It was found that the ECL intensity of the sensor fabricated was greatly enhanced in the presence of metoclopramide.Based on this finding,a highly sensitive and reproducible ECL method was developed for the determination of metoclopramide.The result showed that the ECL intensity was linear with the concentration of metoclopramide in the range from 1.0×10-10 to 5.0×10-7M and the detection limit was 3×10-11M.The ECL sensor exhibited a long-term stability and a fine reproducibility with relative standard deviation of 1.0 % for 1.0×10-10M metoclopramide in 18 continuous determinations.The developed method has been applied to the determination of metoclopramide in tablet samples with satisfactory results.

Normal and reverse flow injection-spectrophotometric determination of thiamine hydrochloride in pharmaceutical preparations using diazotized metoclopramide

Simple and sensitive normal and reverse flow injection methods for spectrophotometric determination of thiamine hydrochloride （THC） at the microgram level were proposed and optimized. Both methods are based on the reaction between THC and diazotized metoclopramide in alkaline medium. Beer＇s law was obeyed over the range of 10 300 and 2-90 ug/mL, the limits of detection were 2.118 and 0.839 ug/mL and the sampling rates were 80 and 95 injections per hour for normal and reverse flow injection methods respectively. The application of both methods to commercially available pharmaceuticals produced acceptable results. The flow system is suitable for application in quality control processes.

Cases Report of a Medication Error by Look-A-Like Packaging: Metoclopramide and Paracetamol Suppositories

Medication errors are Unlike adverse drug reactions (ADRs) or adverse drug events (ADEs);mistakes by healthcare personnel cause them. We reported two cases of developed symptoms of Metoclopramide over-dose. Metoclopramide was given as Paracetamol due to look-a-like packaging. In Emergency Departments, reviewing the patient’s medications to prevent look-a-like complications should be done for all patients with suspected drug toxicity.

Effects of Metoclopramide Orally Disintegrating Tablet in Optimizing Late Outpatient Endoscopy: A Randomized Double-Blind Placebo-Controlled Clinical Trial

Aims: Metoclopramide has been used as a gastro-kinetic agent but the safety and effects of different preparations of metoclopramide on preparation for outpatient endoscopy are largely unknown. The study aimed to evaluate the (1) Safety of using ODT (orally disintegrating tablet) or TT (traditional tablet) metoclopramide pre-endoscopy in non-fasting patients compared with placebo (2) Impact of ODT or TT metoclopramide on sedation and recovery times compared with placebo. Methods: A double blind randomized placebo-controlled trial with 3 arms;Metoclopramide ODT (n = 43), Metoclopramide TT (n = 43) and Placebo (n = 43). Results: Metoclopramide ODT had fewer adverse events compared with TT or placebo. Recovery time was significantly shorter with use of either metoclopramide versus placebo (P < 0.001) & total sedation time was also significantly shorter in the metoclopramide groups versus placebo (P < 0.001). Conclusion: Metoclopramide ODT is safe and beneficial in endoscopic procedures requiring limited access to food and liquid.

Metoclopramide可作为偏头痛的治疗药

甲氧氯普胺作为治疗偏头痛(Metoclopramide)用药同舒马曲坦一样有效。

High Performance Liquid Chromatography for the Determina- tion of Metoclopramide in Pharmaceutical Preparations Using Pre-column Derivatization with Fluorescamine

A simple, rapid and sensitive high performance liquid chromatography （HPLC） method was developed for the determination of metoclopramide in pharmaceutical preparation. The method is based on the derivatization of metoclopramide with fluorescamine. The separation was achieved on a C18 column using methanol-water （70 ： 30, V/V） mobile phase. Fluorescence detector was used at the excitation and emission of 403 and 485 nm, respectively. The method was validated for linearity, limit of detection, limit of quantification, precision, accuracy, recovery, robust- ness and system suitability. The assay was linear over the concentration range of 100-2000 ng/mL. The mean recovery was 100.37%. The proposed method was successfully applied to the assay of metoclopramide in tablet preparation. The preparation was also analyzed with an official method and statistical comparison by t- and F-tests revealed that there was no significant difference between the results of the two methods with respect to mean values and standard deviations at the 95% confidence level.

Effect of metoclopramide administration to mothers on neonatal bilirubin and maternal prolactin: a randomized, controlled, clinical trial

Background Jaundice is a common neonatal problem.This study was conducted to determine the effect of metoclopramide on neonatal bilirubin and maternal prolactin (primary outcomes) and milk volume (secondary outcome).Methods This triple-blind,randomized,controlled,clinical trial was conducted on 112 mothers.The participants were assigned to the intervention (metoclopramide) and control groups (placebo) using block randomization.Ten-mg metoclo-pramide and placebo tablets were taken by the participants three times a day.The intervention began in the first 2-10 hours after childbirth and continued until the fifth day.The mothers' prolactin level was measured on the first morning after the intervention and on the sixth day (1 day after the intervention was over).Neonatal total bilirubin was also measured before the intervention and on the sixth day.Results After the intervention,the two groups did not differ significantly in terms of the mean neonatal indirect bilirubin (P =0.565) and milk volume (P =0.261),but the mean serum prolactin was significantly higher in the metoclopramide group compared to the placebo group (adjusted mean difference 37;95% confidence interval 58.1-16.5;P =0.001).Conclusions Metoclopramide increased maternal serum prolactin but had no effects on neonatal jaundice.The insufficient numbers of studies on this subject mandate further research.

甲氧氯普胺肌内注射及穴位注射治疗顽固性呃逆患者的疗效对比

目的:比较甲氧氯普胺肌内注射及穴位注射治疗顽固性呃逆患者的疗效。方法:选取2020年3月—2021年9月江门市中心医院收治的90例顽固性呃逆患者为对象,按照抽签法分为观察组(甲氧氯普胺穴位注射)和对照组(甲氧氯普胺肌内注射),每组45例。比较两组疗效、中医证候积分、呃逆停止时间、不良反应发生率。结果:观察组总有效率高于对照组(P=0.044);治疗后,两组呃逆、脘腹胀满、胸胁胀满、食少乏力评分降低,观察组低于对照组(P<0.05);观察组呃逆停止时间早于对照组,差异有统计学意义(P<0.001);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:甲氧氯普胺穴位注射治疗顽固性呃逆的效果优于肌内注射,可缩短患者的病程,控制症状,且安全性较高。

中西医结合治疗脑卒中后顽固性呃逆临床观察

目的 探讨中西医结合治疗脑卒中后顽固性呃逆的临床疗效。方法 100例脑卒中后顽固性呃逆患者,应用随机数字表法分为研究组与对照组,各50例。对照组患者采用甲氧氯普胺治疗,研究组患者采用甲氧氯普胺联合中药方剂丁香柿蒂汤治疗。对比两组疗效,不良反应发生率,治疗前后的舒适度评分、心理评分、睡眠状况指标、生活质量评分。结果 研究组治疗总有效率为96.00%,对照组为82.00%,研究组治疗总有效率更高(P<0.05)。研究组中发生2例恶心、1例腹痛,不良反应发生率为6.00%;对照组中发生1例皮疹,不良反应发生率为2.00%。两组不良反应发生率对比,差异无统计学意义(P>0.05)。治疗后,两组舒适度评分、焦虑评分、抑郁评分均较治疗前改善,且研究组舒适度评分(102.80±6.57)分高于对照组的(93.25±6.30)分,焦虑评分(40.90±3.74)分、抑郁评分(41.85±3.81)分低于对照组的(45.61±3.96)、(46.98±4.37)分(P<0.05)。治疗后,两组入睡潜伏期、实际睡眠时长、睡眠质量评分均较治疗前改善,且研究组入睡潜伏期(33.79±7.94)min短于对照组的(42.63±8.75)min,实际睡眠时长(8.04±1.13)h长于对照组的(6.89±1.02)h,睡眠质量评分(10.80±1.31)分低于对照组的(12.56±1.58)分(P<0.05)。治疗后,两组生理、心理、环境、社会关系评分均较治疗前改善,且研究组生理、心理、环境、社会关系评分分别为(89.75±6.48)、(89.07±6.02)、(90.14±6.15)、(89.96±6.27)分,高于对照组的(82.93±6.85)、(82.40±6.13)、(83.27±6.30)、(83.14±6.54)分(P<0.05)。结论 对于脑卒中后顽固性呃逆患者,采用甲氧氯普胺联合中药汤方丁香柿蒂汤的中西医结合疗法可增强治疗效果,提高患者舒适度,有利于改善患者心理、睡眠等状况,提升其生活质量,且不会在用药后增加药物不良反应,安全性良好。

盐酸甲氧氯普胺注射液中有关物质检测方法研究

目的:建立高效液相色谱-加校正因子的主成分自身对照法测定盐酸甲氧氯普胺注射液中的有关物质,为该产品的质量控制和评价提供数据支持。方法:采用赛分Sepax Amethyst C_(18)-H色谱柱(4.6 mm×250 mm,5μm),流动相A为0.02 mol·L^(-1)磷酸溶液(加三乙胺调pH至3.8),流动相B为乙腈,梯度洗脱,流速1.0 mL·min^(-1),柱温35℃,检测波长275 nm,进样量为20μL。结果:主成分峰与各杂质色谱峰分离良好,甲氧氯普胺及各杂质在各自质量浓度范围内与峰面积呈良好线性关系(r=1.0000,n=6),检测限在0.03~0.05μg·mL^(-1),定量限在0.10~0.16μg·mL^(-1),杂质1~5的校正因子分别0.71、0.79、1.10、0.96和0.67;平均回收率为98.7%~100.6%(n=9),重复性、精密度和稳定性均符合相关要求。2家企业6批次的盐酸甲氧氯普胺注射液采用加校正因子的主成分自身对照法测定的结果与对照品外标法基本一致。与国内外药典方法比较,本方法对单杂质、总杂质和特定杂质均进行了控制,且分离效能、检出的杂质个数和杂质量均高于其他药典方法。结论:建立的高效液相色谱-加校正因子的主成分自身对照法可用于盐酸甲氧氯普胺注射液的有关物质测定,为其有关物质质量控制方法的改进提供了数据支持。

四磨汤与胃复安对危重症患者胃潴留的治疗效果研究

目的探讨四磨汤与胃复安对危重症患者胃潴留的治疗效果。方法选取重症加强护理病房(ICU)收治的80例危重症合并胃潴留患者作为研究对象,依据随机纸片法分为四磨汤组和胃复安组,每组40例。比较两组患者的治疗效果、入院急性生理学及慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)评分、入院序贯器官衰竭估计评分(SOFA)、ICU住院时间、机械通气时间、并发症发生率。结果胃复安组患者的总有效率为80.00%,与四磨汤组的87.50%比较,差异无统计学意义(P>0.05)。胃复安组患者的入院APACHE-Ⅱ评分、入院SOFA评分、ICU住院时间、机械通气时间、并发症发生率分别为(23.65±5.62)分、(9.87±1.23)分、(10.02±4.40)d、(70.68±6.72)h、22.50%,与四磨汤组的(24.18±6.07)分、(9.62±1.98)分、(11.90±4.84)d、(72.37±6.53)h、15.00%比较,差异无统计学意义(P>0.05)。结论四磨汤与胃复安在危重症患者胃潴留中的治疗效果相当。

甲氧氯普胺联合苯海拉明对眩晕所致呕吐患者止吐效果的影响

目的探究甲氧氯普胺联合苯海拉明对眩晕所致呕吐患者止吐效果的影响。方法选取北京怀柔医院120急救分中心2020年6月~2023年6月经治的165例眩晕所致呕吐患者,按照随机数字法分为对照组(n=82)和研究组(n=83),其中对照组采用甲氧氯普胺进行治疗,研究组采用甲氧氯普胺联合苯海拉明进行治疗。比较两组患者治疗前后的眩晕症状、血压水平、生命体征指标以及末梢指血氧饱和度水平,评估止吐效果。结果治疗前,两组患者的眩晕症状评分比较,差异无统计学意义(P>0.05);治疗后,研究组的眩晕症状评分明显低于对照组,差异有统计学意义(P<0.05);治疗前,两组患者的SBP、DBP水平对比,差异无统计学意义(P>0.05),治疗后,研究组的SBP、DBP水平明显低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的HR、RR、SpO_(2)水平对比差异无统计学意义(P>0.05),治疗后,研究组的HR、RR水平明显低于对照组,SpO_(2)水平明显高于对照组,差异有统计学意义(P<0.05);治疗后,研究组的总止吐有效率明显高于对照组,差异有统计学意义(P<0.05)。结论相较于甲氧氯普胺单一用药,甲氧氯普胺联合苯海拉明应用于眩晕所致呕吐患者止吐的效果更好,可有效改善患者的临床状况、生命体征,降低不良反应的发生。

甲氧氯普胺联合异丙嗪对妊娠剧吐患者呕吐症状及生活质量的影响

目的分析甲氧氯普胺联合异丙嗪在妊娠剧吐患者中的治疗效果。方法方便选取2020年5月-2022年4月六盘水市人民医院收治的妊娠剧吐患者86例为研究对象,按随机数表法分为两组,各43例。对照组予以甲氧氯普胺,观察组加用异丙嗪,连续治疗1周。对比两组临床疗效、症状改善情况、呕吐症状严重程度、生活质量、不良反应。结果观察组治疗总有效率为93.02%,高于对照组的76.74%,差异有统计学意义(χ^(2)=4.441,P<0.05),观察组的呕吐消失时间、尿酮转阴时间短于对照组,差异有统计学意义(P均<0.05);治疗前,两组孕期恶心呕吐量化表(Pregnancy-unique Quantification of Emesis and Nausea,PUQE)评分与妊娠恶心呕吐生活质量量表(Nausea and Vomiting of Pregnancy Quality of Life Questionnaire,NVPQOL)评分相比,差异无统计学意义(P均>0.05)。治疗后,观察组PUQE评分、NVPQOL评分低于对照组,差异有统计学意义(P均<0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论甲氧氯普胺+异丙嗪治疗妊娠剧吐患者效果显著,可减轻其呕吐症状,促进尿酮转阴,提升生活质量,且无严重不良反应。

三种不同止吐方案预防化疗所致恶心呕吐的费用—效果分析

目的 :从几组化疗止吐剂中筛选一帖经济有效、便于推广应用的止吐处方。方法 :采用CCT将 14 9例非顺铂化疗病人分为A、B、C三组。A组 5 2例 ,使用国产格拉司琼 ;B组 4 7例 ,用恩丹西酮 ;C组 5 0例 ,用胃复安 +地塞米松。以止吐效果为主要指标进行多侧面观察比较。结果 :止恶心、止吐有效率 ,A组有效率分别为 92 3%～ 94 2 % ,B组为 87 2 %～ 89 3% ,C组有效率分别分 4 8 0 %～ 6 8 0 %。A、B、C三组的不良反应发生率分别为 2 5 0 %、 36 2 %、5 2 0 %。结论 :格拉司琼可作为非顺铂化疗止吐首选用药 ,恩丹西酮可作为非顺铂化疗止吐次选用药 ,胃复安

反相高效液相色谱法测定家犬体内甲氧氯普胺的血药浓度

目的:建立测定甲氧氯普胺血浆浓度的高效液相色谱法。方法:血浆样品在碱性条件下用乙醚提取,盐酸曲马多为内标,采用 Hypersil-C_(18)(4.6mm×200mm,5μm)柱,流动相为甲醇-乙腈-醋酸盐缓冲液(pH 4.0)-三乙胺(7:18:75:0.1),检测波长273nm,甲氧氯普胺与内标的保留时间分别为4.9min 和7.1min。结果:线性范围为5-100ng·mL^(-1)(r=0.9993);最低检测浓度为1ng·mL^(-1);日内、日间精密度 RSD 分别为2.4%-6.8%,3.6%-8.6%(n=5);低、中、高3个浓度的提取回收率分别为81.5%,84.6%,80.4%;方法回收率为96.6%,98.5%,101.2%。结论:本方法灵敏度高,简便易行,能满足甲氧氯普胺的药物动力学研究。

不同止吐药预防术后PCA恶心呕吐的临床观察

目的 探讨各种止吐药预防术后芬太尼静脉PCA恶心呕吐的效果。方法 选择硬膜外麻醉下行开腹手术患者 83例 ,术毕接PCA泵行芬太尼静脉PCA(PCIFA)。并随机分成四组 ,C组 :不给止吐药 ;M组 :甲氧氯普胺 10mg ;O组 :恩丹西酮 8mg ;N组 :欧必亭 5mg。 结果 N组术后12小时和 2 4小时止恶心、呕吐作用均明显优于其他三组 ;恶心、呕吐发生率O组仅于术后 12小时稍有降低 ,而N组术后 12和 2 4小时下降均明显。结论 欧必亭与恩丹西酮、甲氧氯普胺比较 ,能更有效地防治PCIFA引起的恶心。