Paper II
2014 September (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Mechanism of action of metoclopramide

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Answer

Metoclopramide is a dopamine D2 receptor antagonist (and 5-HT4 agonist at higher doses) that acts both centrally and peripherally: centrally, it blocks D2 receptors in the chemoreceptor trigger zone, producing an antiemetic effect; peripherally, it enhances acetylcholine release and increases gastric/upper GI motility (prokinetic effect) — increasing lower oesophageal sphincter tone, gastric emptying, and antroduodenal coordination.

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