Document Detail


Slower infusion of metoclopramide decreases the rate of akathisia.
MedLine Citation:
PMID:  19555621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Linda A Regan; Robert S Hoffman; Lewis S Nelson
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  27     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-06-26     Completed Date:  2009-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  475-80     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. lregan@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
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:
0/Antiemetics; 364-62-5/Metoclopramide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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