| Slower infusion of metoclopramide decreases the rate of akathisia. | |
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MedLine Citation:
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PMID: 19555621 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We investigated the difference in incidence of acute akathisia related to the rate of infusion in patients receiving metoclopramide for acute nausea, vomiting, or migraine headache in the emergency department (ED). METHODS: Randomized, prospective, double-blind clinical trial of patients aged 18 years and older who were to receive intravenous metoclopramide for the treatment of nausea, vomiting, or headache were eligible. Patients were excluded if they were taking medications that might mimic or mask akathisia, had a movement disorder, renal insufficiency, or were unable or unwilling to consent. Pregnant women and prisoners were also excluded. Subjects were randomized to receive 1 of 2 accepted metoclopramide administration regimens. The regimens included 10 mg of metoclopramide administered either as a 2-minute bolus (BG) or as a slow infusion for 15 minutes (IG). All patients received a normal saline placebo at the opposite rate to maintain blinding. The main outcome was development of akathisia noted at 60 minutes after drug administration as measured either with The Prince Henry Hospital akathisia rating scale or by sudden unexplained departure from the ED during treatment. RESULTS: One hundred twenty-seven patients were eligible for the study. Fifty-nine patients met exclusion criteria. Of the remaining 68 patients, 36 were randomized to the BG and 32 were randomized to the IG. In the BG, 11.1% of patients developed akathisia compared with 0% in the IG (P = .026). Four patients developed akathisia based on the scale and 2 departed suddenly from the ED. CONCLUSIONS: Slower infusion of metoclopramide reduces the incidence of akathisia. |
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Authors:
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Linda A Regan; Robert S Hoffman; Lewis S Nelson |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 27 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-06-26 Completed Date: 2009-07-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 475-80 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. lregan@jhmi.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antiemetics / administration & dosage*, adverse effects Double-Blind Method Female Humans Infusions, Intravenous / methods* Male Metoclopramide / administration & dosage*, adverse effects Middle Aged Prospective Studies Psychomotor Agitation / etiology, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Antiemetics; 364-62-5/Metoclopramide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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