Metoclopramide in gastroesophageal reflux of infancy

Machida, H; Forbes, David; Gall, David; Scott, Robert B.

doi:10.1016/s0022-3476(88)80345-7

Cited by 66 publications

(29 citation statements)

References 20 publications

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“…The presence of these symptoms in young children and infants may predispose to even more respiratory compromise, namely apnea, in addition to the previously reported symptoms of restlessness, anxiety and sudden death. 2,9,11 Most of our patients received doses of the drug that were more than the recommended therapeutic dose of 0.15 mg/kg/dose 6 or 0.7 mg/kg/day. 9 However even with standard therapeutic doses, neurological side effects were reported.…”

Section: Discussionmentioning

confidence: 96%

“…2,9,11 Most of our patients received doses of the drug that were more than the recommended therapeutic dose of 0.15 mg/kg/dose 6 or 0.7 mg/kg/day. 9 However even with standard therapeutic doses, neurological side effects were reported. The absorption of metoclopramide is rapid throughout the gastrointestinal tract with variable peak plasma levels according to the route of administration.…”

Section: Discussionmentioning

confidence: 96%

“…Furthermore, the value of metoclopramide, even for the above-mentioned indications, is recently debated. [6][7][8][9][10] Despite all of this, metoclopramide remains a popular antiemetic, used widely in developing countries as it is readily accessible to patients and physicians. The estimated prevalence of neurological side effects in our study of 0.6% represents only the tip of the iceberg, as we feel that mild symptomatology may be overlooked by patients and parents.…”

Section: Discussionmentioning

confidence: 99%

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Neurological Side Effects Associated with Unnecessary Use of Metoclopramide in Children

Zaben

Herbish²

1995

Ann Saudi Med

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AA Al Zaben, AS Al Herbish, Neurological Side Effects Associated with Unnecessary Use of Metoclopramide in Children. 1995; 15(2): 183-184 Incidence of side effects of metoclopramide is 20%.1 Neurological symptoms such as oculogyric crisis and involuntary contractions of the eye muscles leading to upward conjugate gaze occur in about 1% of patients. 2Children and young adults are more prone to develop these symptoms, even after a single dose. 3,4 Despite the fact that these effects disappear spontaneously and completely after discontinuation of this treatment, they create unnecessary anxiety for the patient, parents and health care personnel. This problem would not have emerged without the uncontrolled, and most of the time unnecessary, prescription of metoclopramide to young children. In this study, over a one-year period, we analyzed the clinical data of 24 children who presented with these manifestations after being prescribed metoclopramide for an acute illness. Material and MethodsClinical data and hospital course of children presenting over a one-year period (starting July 1991) to the emergency room of the Pediatric Department of the Riyadh Medical Complex with neurological symptoms due to metoclopramide (primperan or plasil) were analyzed. The number of admissions to this emergency unit was 30 to 50 children per day with various acute pediatric problems. Age, weight, indicating symptoms for prescribing metoclopramide, dose given, frequency and route of administration were all recorded. The specific neurological symptom and/or sign, e.g., oculogyric crisis defined as involuntary contractions of the eye muscles resulting in upward conjugate gaze, dystonia, drowsiness, etc. was elicited at presentation and its course thereafter was followed. Some children were given diazepam to abort or lessen these symptoms and the rest resolved spontaneously.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Neurological Side Effects Associated with Unnecessary Use of Metoclopramide in Children

Zaben

Herbish²

1995

Ann Saudi Med

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“…Its clinical success has not been confirmed, however. In a small double-blind controlled trial using intra-oesophageal p H monitoring, metaclopramide was shown actually to increase the number of reflux epsidoes recorded despite increasing the lower oesophageal sphincter pressure and treatment was associated with patient irritability (26). In adults, metoclopramide and domperidone may be helpful in decreasing the severity of regurgitation (27,28) but although symptoms of oesophagitis have been improved in double-blind controlled trials they have not been shown to reduce the number of reflux episodes measured during ambulatory pH monitoring (29) or to improve the endoscopic appearance of the oesophagus (30).…”

Section: Increasing Gastro-oesophageal Motilitymentioning

confidence: 98%

Therapeutic Progress—review Xxxiii: Are We Making Progress in the Drug Treatment of Oesophageal Disease?

Deakin

Temple

1988

J Clin Pharm Ther

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“…4 In four randomized controlled studies of metoclopramide in children, two reported a decrease in the frequency and volume of vomiting, but two reported symptoms to be no better or worse than the placebo treated group. [42][43][44][45] The central nervous system adverse effects of metoclopramide limit its use, most notably extrapyramidal side effects.…”

Section: Prokinetic Therapymentioning

confidence: 99%

Clinical Management of Infants and Children with Gastroesophageal Reflux Disease

Whitworth¹,

Christensen

2004

The Journal of Pediatric Pharmacology and Therapeutics

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Gastroesophageal reflux refers to the passage of gastric contents including food, acid, and digestive enzymes up into the esophagus. Reflux is most commonly recognized in infants when it is associated with regurgitation, known as “spitting up,” and it is usually a self-limited, benign process that has little or no effect on normal weight gain or development. Adults and adolescents may also have reflux, which is usually either asymptomatic or recognized as dyspepsia or “heartburn.” Gastroesophageal reflux disease (GERD) is defined as symptoms or complications that result from reflux. Most evidence suggests the mechanism of reflux is due to transient relaxations of the lower esophageal sphincter at inappropriate times. The diagnosis of suspected GERD in infants and children depends on the age and the presenting symptoms. A thorough history, physical examination, and growth charts are sufficient for the evaluation and diagnosis of GERD in most infants with recurrent vomiting or children with regurgitation and heartburn. Additional evaluation may include an upper gastrointestinal series, esophageal pH monitoring, or endoscopy. The goals of GERD management are eliminating symptoms, healing esophagitis, preventing complications, promoting normal weight gain and growth, and maintaining remission. Therapeutic options include lifestyle changes, pharmacologic therapy, and anti-reflux surgery. Currently available pharmacologic agents for the treatment of GERD include antacids, mucosal protectants, prokinetic agents, and acid suppressants.

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Metoclopramide in gastroesophageal reflux of infancy

Cited by 66 publications

References 20 publications

Neurological Side Effects Associated with Unnecessary Use of Metoclopramide in Children

Neurological Side Effects Associated with Unnecessary Use of Metoclopramide in Children

Therapeutic Progress—review Xxxiii: Are We Making Progress in the Drug Treatment of Oesophageal Disease?

Clinical Management of Infants and Children with Gastroesophageal Reflux Disease

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