Metoclopramide – Induced Extrapyramidal Signs and Symptoms – Brief Review of Literature and Case Report

Valkova, Mirena; Stamenov, Boyko; Peychinska, Dora; Veleva, I.; Dimitrova, P.; Radeva, Pavlina

doi:10.5272/jimab.2014206.539

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…Meskipun obat metoklopramid memiliki efek yang signifikan dalam mengobati mual dan muntah, serta merupakan obat agonis reseptor dopamin dan gen antiemetik yang paling terkenal, tetapi penggunaannya telah dibatasi oleh European Medicines Agency (EMA) karena dapat menyebabkan efek samping neurologis akut dan kronis. 29 Efek samping neurologis yang sering muncul akibat dari penggunaan obat metoklopramid adalah EPS dengan gejala di antaranya parkinsonisme, distonia akut, akathisia dan bahkan bisa menjadi diskinesia tardiv jika tidak terobati dengan benar. 30 Diskinesia tardiv merupakan suatu sindrom yang ditandai oleh gerakan berulang pada bibir, lidah, dan wajah yang persisten dan berpotensi ireversibel.…”

Section: Karakteristik Pasienunclassified

Hubungan Pemberian Terapi Antipsikotik terhadap Kejadian Efek Samping Sindrom Ekstrapiramidal pada Pasien Rawat Jalan di Salah Satu Rumah Sakit di Bantul, Yogyakarta

Dania

Faridah

Rahmah

et al. 2019

ijcp

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AbstrakSkizofrenia merupakan penyakit gangguan jiwa terbanyak yang memiliki prognosis yang buruk, dengan remisi total hanya dialami oleh sekitar 20% penderitanya, sedangkan sisanya akan mengalami berbagai tingkat kesulitan dan kemunduran secara klinis dan sosial. Antipsikotik merupakan terapi utama pada skizofrenia, namun pemberian terapi ini terkadang dapat menimbulkan efek samping, salah satunya adalah sindrom ekstrapiramidal yang dapat menyebabkan pasien enggan untuk minum obat secara rutin, akibatnya frekuensi kekambuhan menjadi meningkat. Penelitian ini bertujuan untuk menganalisis hubungan terapi antipsikotik terhadap kejadian sindrom ekstrapiramidal pada pasien skizofrenia rawat jalan di salah satu rumah sakit di wilayah Bantul, Yogyakarta. Penelitian ini merupakan penelitian observasional dengan desain penelitian cross-sectional dengan pengambilan data secara retrospektif menggunakan data rekam medis pasien skizofrenia yang menjalani rawat jalan di salah satu rumah sakit di wilayah Bantul, Yogyakarta pada periode Januari-Desember 2017. Jumlah sampel dalam penelitian ini adalah 100 orang pasien dengan kriteria inklusi yaitu pasien skizofrenia dengan usia >15 tahun dan mendapatkan terapi antipsikotik selama minimal 4 minggu, sedangkan kriteria ekslusi yaitu pasien yang mendapatkan terapi metoklopramid dan mempunyao riwayat sindrom ekstrapiramidal sebelumnya. Pengambilan sampel dilakukan menggunakan teknik purposive sampling. Analisis data menggunakan uji Chi-Square dengan menggunakan program SPSS versi 16.0. Diperoleh bahwa sebagian besar pasien mendapat risperidon sebesar 27%, risperidon+klozapin 17%, dan haloperidol+klozapin 10%. Pada pasien yang memperoleh terapi antipsikotik tunggal, sebanyak 5 orang mengalami efek samping sindrom ekstrapiramidal, sedangkan pada pasien yang memperoleh terapi antipsikotik kombinasi, 7 orang mengalami efek samping sindrom ekstrapiramidal. Hasil analisis uji Chi-Square menunjukkan bahwa tidak terdapat hubungan baik itu antara penggunaan terapi antipsikotik Abstract Schizophrenia is the most kind of psychiatric diseases which has bad prognosis with total remision only around 20%, otherwise social and clinical difficulties will be faced by the rest. Antipsychotic is a first line therapy for schizophrenic patients, however it has some side effects such as extrapyramidal syndrome that make people reluctant to take the medication regularly. Furthermore, the number of recurrence is increasing. The aim of this study was to analyze the relationship between the use of antipsychotic and the incident of extrapyramidal syndrome in outpatient schizophrenia in one of hospitals in Bantul region, Yogyakarta. This study was observational study, using cross-sectional design. Data was taken retrospectively using patients' medical records who were outpatients in one of hospitals in Bantul region, Yogyakarta, in the period of January-December 2017. The sample of this research was 100 patients. The inclusion criteria was schizophrenic patients aged >15 years old who took an antipsychotic therap...

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Section: Karakteristik Pasienunclassified

Hubungan Pemberian Terapi Antipsikotik terhadap Kejadian Efek Samping Sindrom Ekstrapiramidal pada Pasien Rawat Jalan di Salah Satu Rumah Sakit di Bantul, Yogyakarta

Dania

Faridah

Rahmah

et al. 2019

ijcp

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“…Acute dystonic reactions due to metoclopramide use have been reported to occur in 0.2–25.0% of patients. 7 , 8 Little has been done regarding research on metoclopramide-induced dystonic reactions in the developing world, which is surprising given the medication’s increased prescriptions and accessibility as an over-the-counter anti-emetic. Due to the dearth of data collection and under-reporting of cases, the incidence of these reactions is underestimated.…”

Section: Discussionmentioning

confidence: 99%

Metoclopramide-induced Acute Dystonia Misdiagnosed as an Epileptic Seizure in a Lupus Patient

Emorinken¹,

Agbadaola²

2021

J Epilepsy Res

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Acute dystonic reactions are the most prevalent extrapyramidal adverse effects associated with metoclopramide. It could be mistaken for a variety of other conditions, such as seizures, tetanus, and encephalitis, to name a few possibilities. We present a case of a 26-year-old female misdiagnosed as having an epileptic seizure who was rushed to the emergency unit with an involuntary bilateral upward deviation of the eyes, spasm, stiffness, lateral deviation of the neck, and protrusion of the tongue. Symptoms occurred 36 hours after the commencement of metoclopramide, used to treat nausea and vomiting in the referring hospital. All the laboratory work was normal. The drug was discontinued and 5 mg of intravenous biperiden was administered. The symptoms subsided in about 10 minutes with no recurrence. Metoclopramide-induced acute dystonia not only creates an anxious environment for patients but may also be life-threatening. Due to the high probability of misdiagnosis, detailed drug history and a high index of suspicion are critical in making the correct diagnosis.

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“…28 Metoclorpiramide is used to treat the nausea and vomiting often accompanying acute migraines. 29 Vitamin C is used in the treatment of hyperpigmentation. 30 Levofloxacin produces a broad spectrum of activity against several causative bacterial pathogens of community-acquired pneumonia (CAP).…”

Section: Discussionmentioning

confidence: 99%

Herbal-induced Stevens-Johnson syndrome with oral involvement and management in an HIV patient

Suniti

Sufiawati

2018

Dent. J.

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Background: Stevens-Johnson syndrome (SJS) is an immune complex-mediated hypersensitivity reaction affecting the skin and mucous membranes. Patients infected with human immunodeficiency virus (HIV) are at increased risk of developing SJS which is predominantly caused by an adverse reaction to medications, including herbal varieties. In recent years, the consumption of herbal medicines has increased, while their safety remains a matter for investigation. Purpose: The purpose of this case report is to explain the occurrence of SJS caused by herbal medicine. Case: A 43-year-old male patient with body-wide skin erosion was referred to the Department of Oral Medicine and subsequently diagnosed with Stevens-Johnson syndrome due to his consumption of a herbal medicine containing zingiber rhizoma, coboti rhizoma, asari herbal and epimedi. The patient’s chief complaints included difficulty when opening the mouth, dysphagia and excessive production of saliva continuously contaminated with blood and sputum. Extraoral examination showed a sanguinolenta crust on the lips. Intra oral examination of oral mucous showed erosive lesions with bleeding and pain. A HIV test performed at a Clinical Pathology Laboratory was positive for antibodies against HIV with a CD4 cell count of 11 cells/ml. Case management: Treatment consisted of the administering of NaCl 0.9 %, hydrocortisone 0.1% and Chlorhexidine digluconate 0.12% for 12 days. Conclusion: SJS can be caused by herbal medicine and it is essential to be aware of the latter’s potential adverse effects, especially in immunocompromised patients. Symptomatic management of oral lesions should be planned as an early intervention in order to decrease morbidity and mortality in SJS patients.

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Metoclopramide – Induced Extrapyramidal Signs and Symptoms – Brief Review of Literature and Case Report

Cited by 9 publications

References 12 publications

Hubungan Pemberian Terapi Antipsikotik terhadap Kejadian Efek Samping Sindrom Ekstrapiramidal pada Pasien Rawat Jalan di Salah Satu Rumah Sakit di Bantul, Yogyakarta

Hubungan Pemberian Terapi Antipsikotik terhadap Kejadian Efek Samping Sindrom Ekstrapiramidal pada Pasien Rawat Jalan di Salah Satu Rumah Sakit di Bantul, Yogyakarta

Metoclopramide-induced Acute Dystonia Misdiagnosed as an Epileptic Seizure in a Lupus Patient

Herbal-induced Stevens-Johnson syndrome with oral involvement and management in an HIV patient

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