Prokinetic Dopamine Receptor Antagonists

Metoclopramide is indicated for the treatment of chemotherapy induced nausea as well as for treatment of gastroparesis.  Gastroparesis is a condition characterized by a lack of motility of the stomach, which can result in pain and nausea.  Metoclopramide induces gastric motility and reduces nausea by inhibiting dopamine in the chemoreceptor trigger zone.  As with other dopamine receptor antagonists, akathisia, tardive dyskinesia, and dystonia are potential side effects.  

Class Drugs

• Metoclopramide

Class Mechanism of Action

Inhibits dopamine receptors in the chemoreceptor trigger zone, reducing nausea

Inhibits dopamine receptors peripherally resulting in increased lower esophageal sphincter tone, increased gastric contractility, and improved gastric motility

Class Applications

Chemotherapy induced nausea

Gastroparesis

Class Adverse Effects

Akathisia

Tardive dyskinesia

Dystonia

Black Box Warning: Risk of tardive dyskinesia, especially with prolonged use or high doses

Contraindicated in GI obstruction, perforation, or hemorrhage

Drug Table

Drug Name	Application	Comments	Image
Metoclopramide			"Mets Logo" "Cop" "Ram"