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Metoclopramide induced extrapyramidal syndrome in 1 case report of child_32137

By Stanley Woods,2014-11-02 09:48
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Metoclopramide induced extrapyramidal syndrome in 1 case report of child_32137

    Metoclopramide induced extrapyramidal syndrome in 1 case report of child

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     [Keywords:] metoclopramide extrapyramidal syndrome in children

     Until the spit metoclopramide drug for the treatment of vomiting after chemotherapy and surgery can also be used for duodenal ulcer, pyloric obstruction. The side effects of clinical manifestations of neck stiffness, limb numbness, seizures, strabismus. Now Court met metoclopramide induced extrapyramidal syndrome in 1 case of children reported as

    follows.

     1 Case information

     Children, male, 7 years old, accompanied by vomiting due to acute bronchial pneumonia, the local clinic to give intramuscular metoclopramide 15mg, about 3h after limb tremor, paroxysmal right to reverse the neck muscle spasm. 2h after

    the onset of my hospital treatment. admission examination: clear consciousness, crying, neck strong (+-), lungs could be

    heard and auscultation, heart and abdomen revealed no abnormalities, limb muscle strength normal, slightly increased

    muscle tone, Clinton sign (-), Brandt sign (-), other

    neurological examination no positive signs. related auxiliary examination: blood, urine, they are normal routine and biochemical series. diagnosis of metoclopramide overdose induced extrapyramidal reactions. immediately after admission atropine 0.01mg / (kg ?? times) intermittent intravenous injection, while giving the energy mixture and vitamin C intravenously. 8h after admission significantly reduced the symptoms, seizure frequency decreased gradually shortened the

    duration of each episode, treatment 12h after the symptoms disappear. consolidating the treatment for 3 days, the disease was discharged without repeated.

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     2 Discussion

     Department of metoclopramide block dopamine receptors can act on the feelings of the medullary emetic chemical area, with a strong central antiemetic effect on vomiting caused by various reasons, has a good effect [1]. If the long-term high-

    dose Application of metoclopramide may be due to blocking

    dopamine receptors, so the relative cholinergic receptor extrapyramidal reaction caused by hyperthyroidism [2]. mechanism may be: (1) children with immature blood-brain

    barrier; (2) Metoclopramide blocks dopamine receptors or dopamine depletion of the extrapyramidal system of storage, so that the function of acetylcholine in the emergence of extrapyramidal excited relative increase symptoms. clinical manifestations of acute dystonia, Parkinson's syndrome. Metoclopramide induced extrapyramidal symptoms related to drug use. oral incidence of extrapyramidal symptoms were within 1 day, and intramuscular injection are mostly occurs in about 2min, and its symptoms are dose-related. oral or intramuscular

    injection should be <0.2mg / (kg ?? d), are more vulnerable

    than the dose of extrapyramidal symptoms. metoclopramide mainly excreted by the kidneys. Children usual dose: oral Administration of 0.3 ~ 0.5 mg / (kg ?? d), 3 times meal before taking, or muscle or intravenous 0.3 ~ 0.5 mg / (kg ??

    d), 3 times. the children of drug overdose induced extrapyramidal symptoms. in the event of overdose or extrapyramidal symptoms occur anticholinergic drugs available atropine to relieve symptoms. paediatricians should be strictly controlled metoclopramide dose in children, closely

    observed after treatment, adverse reactions should be treated.

     [References] 1 State Food and Drug Administration Center for Drug Evaluation. Drug clinical information for reference. Chengdu: Sichuan Science and Technology Press, 2004,577.

    2 Shen Gang, Ren Jin Xiang. New Practical pediatric drug handbook. Beijing: People's Medical Publishing

    House ,2006,306-307.

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