Dimethicone + Metoclopramide Pharmacology
Dimethicone + Metoclopramide
Dimethicone
Antiflatulents are added to an antacid gum coating to be effective antigas materials and eliminate trapped gas. The most common antigas material is Dimethicone and when mixed with silicone dioxide becomes Simethicone. Simethicone is also referred to as activated Dimethicone. Simethicone is the most common antigas material and may be the only drug approved antiflatulent.
As the antacid chewing tablet is chewed, the active antacid and antiflatulent in the gum coating is released into the saliva and ingested to give relief from gastrointestinal disturbances in the gastro-intestinal tract.
Besides its antigas effect, Simethicone used in a gum coating can also improve the smoothness of the coating. Activated Dimethicone helps to relieve pain and bloating caused by trapped wind.
2. Postoperative distension
3. Gastric Distention
4. Functional digestive disorders
5. Stomach pain
6. Burning
7. Nausea and excess gas (dyspepsia)
Dimethicone in a coated chewing gum: 5 mg - 200 mg per piece of coated gum.
With an antacid: 20 mg -50 mg of Dimethicone
Metoclopramide
Antiemetic action: Metoclopramide inhibits Dopamine receptor in the chemoreceptor trigger zone and produces antiemetic action.
Intestinal motility modifying action: The binding of Metoclopramide on 5HT4 receptor will activate interneuron and enhance the release of acetylcholine innervating the smooth muscles. This produces gastric emptying and enhances lower esophageal sphincter tone.
Migraine: Metoclopramide is used in migraine to relieve nausea and vomiting
Anaesthetic adjuncts: It is used preoperatively in order to reduce the post operative vomiting.
Metabolism: Only a small amount undergoes hepatic metabolism. Excretion: It is excreted mainly in urine and faeces.
IM: 10 - 15 minutes
IV: 1 - 3 minutes
2.Confusion
3.Constipation
4.Muscle spasm
5.Tremor
6.Bronchospasm
7.Bradycardia
8.Fatigue
9.Headache
10.Dizziness
11.Nervousness
12.Sedation
13.Nausea
14.Rash
2.Gastrointestinal haemorrhage
3.Mechanical obstruction
4.Pheochromocytoma
5.Epilepsy
6.Parkinsonism
7.Pyloric stenosis
8.Previous history of dystonia
2. Depression
3. Renal impairment
4. Hepatic impairment
5. Use with caution while driving vehicles, operating machines and people involving any other dangerous activities
NEONATES: contraindicated
a)associated with various gastrointestinal disorders and migraine
b) Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy.
c) Post operative nausea and vomiting
2. Treatment of delayed gastric motility
3. Gastroesophageal reflux
4. Diagnostic procedure in gastroenterology
Alcohol, sedatives, hypnotics, narcotics or tranquilizers: Additive sedative effect may occur.
Digoxin, Cimetidine: Absorption of these drugs decreased.
Acetaminophen, Aspirin: The absorption of these agents increased.
Phenothiazines, Butyrophenone, Lithium and Thioxanthine drugs: May potentiate extrapyramidal effects.
Bromocriptine: Antagonism of hypoprolactinaemic effect of bromocryptine.
Cyclosporine: May lead to increased cyclosporine absorption, possibly increasing immunosupressive and toxic effect.
Succinylcholine: Metoclopramide may increase the neuromuscular blocking effects of succinylcholine.
ORAL: 15 - 30 mg / day in 3 divided doses.
Treatment of delayed gastric motility: 10 mg to be taken 30 minutes before each meal and at bed time for3 months. Drug is given depending upon the symptom being treated and clinical response.
Gastroesophageal reflux: 10 - 15 mg 4 times a day, drug to be taken half an hour before each meal and at bed time.
INJECTION:
Post operative nausea and vomiting: 10 - 20 mg IM at the end of surgical procedure and repeat the dose every 4 - 6 hours if needed
Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy: 2 - 4 mg / kg as IV infusion over 15 - 30 minutes.
Maintenance dose: 3 - 5 mg / kg given over 8 hours
Maximum dose: 10 mg / kg / day.
Children:
ORAL: 0.4 mg / kg / day in 4 divided doses.
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