Paper II — 2022 May (Supplementary) (2010 Scheme) — Q6

Paper II

2022 May (Supplementary) (2010 Scheme)

Question

Metoclopramide

Q63 marksShort Notes★✓

Answer

Metoclopramide is a D2 receptor antagonist with an additional prokinetic action.

MOA: metoclopramide → blocks D2 receptors at the chemoreceptor trigger zone → antiemetic effect; also acts as a 5-HT4 agonist and D2 antagonist within the GI tract itself → increases gastric emptying and lower esophageal sphincter tone (genuine prokinetic action, distinct from its pure antiemetic effect).

Uses: nausea and vomiting (including chemotherapy-induced and postoperative), gastroparesis, GERD-related symptoms, as an aid to radiological GI procedures (accelerates gastric emptying).

Adverse effects: extrapyramidal symptoms (dystonia, akathisia — since it crosses the blood-brain barrier and blocks central D2 receptors, unlike domperidone), hyperprolactinemia/galactorrhea, drowsiness, diarrhea.

Related Concepts

1. 1Antiemetics

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