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Digesprid

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Indications:

Bromopride is indicated in the treatment of nausea and vomiting, including postoperative nausea and vomiting.

Contraindications:

should not be used when stimulation of muscular contractions might adversely affect gastrointestinal conditions, as in gastrointestinal haemorrhage, obstruction, perforation, or immediately after surgery. There have been reports of hypertensive crises in patients with phaeochromocytoma given metoclopramide, thus its use is not recommended in such patients

Adverse reactions:

may cause extrapyramidal symptoms (usually acute dystonic reactions); these are more common in children and young adults, especially if female, and at daily doses above 500 micrograms/kg. Parkinsonism and tardive dyskinesia have occasionally occurred, usually during prolonged treatment in elderly patients. Other adverse effects include restlessness, drowsiness, and diarrhoea. Hypotension, hypertension, dizziness, headache, and depression may occur and there are isolated reports of blood disorders, hypersensitivity reactions (rash, bronchospasm), and neuroleptic malignant syndrome. Disorders of cardiac conduction have been reported with intravenous metoclopramide. it may also stimulates prolactin secretion and may cause galactorrhoea or related disorders. Transient increases in plasma-aldosterone concentrations have been reported.

Interactions:

should be used with caution in patients taking other drugs that can also cause extrapyramidal reactions, such as the phenothiazines. Increased toxicity may occur if it is given to patients receiving lithium, and caution is advisable with other centrally active drugs such as antiepileptics. Antimuscarinics and opioid analgesics antagonise the gastrointestinal effects The absorption of other drugs may be affected by it may either diminish absorption from the stomach (as with digoxin) or enhance absorption from the small intestine (for example, with ciclosporin, aspirin, or paracetamol). It inhibits serum cholinesterase and may prolong neuromuscular blockade produced by suxamethonium and mivacurium may also increase prolactin blood concentrations and therefore interfere with drugs which have a hypoprolactinaemic effect such as bromocriptine It has been suggested that it should not be given to patients receiving MAOIs.

Warnings:

the dose of should be reduced in patients with clinically significant hepatic impairment,has been associated with acute attacks of porphyria and is considered to be unsafe in porphyric patients

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