Reglan

Reglan Use for Treating Stomach Paralysis

Stomach paralysis, which is technically known as gastroparesis, is a condition where digested food takes an excessive amount of time in order to move from the stomach to the upper intestinal tract or fails to move at all. It is the result of damage to the vagus nerve, which controls the contractions of the stomach that move digested food into the intestines. Such damage may be caused by:

  • Diabetes
  • Surgery or trauma
  • Cancer chemotherapy or radiation treatments
  • Eating disorders
  • Parkinson's disease
  • Autoimmune disease
  • Genetic disorder

Approximately 33 percent of all cases have no apparent cause, but are likely to be attributed to viral infections. Gastroparesis can be either chronic or transient and is commonly treated with the use of metoclopramide, better known as Reglan.

How Reglan Works

Like many types of antipsychotic or neuroleptic drugs, Reglan operates as a dopamine antagonist by blocking electro-chemical signals from the brain to various parts of the body. When the dopamine carrying these signals is prevented from reaching receptors in stomach cells, contractions may result, forcing food into the intestinal tract.

Risks of Reglan

Reglan has been discovered to cause side effects in one in five patients. These side effects can appear in as little as a few days and run from minor to life-threatening, particularly when the drug is taken for a period exceeding three months. Extreme tiredness or agitation and restlessness are the most common one side effects, but other symptoms such as uncontrollable arm and leg movements can develop.

When the drug is taken for longer than three months, clinical depression, symptoms of Parkinson's disease and tardive dyskinesia symptoms can result. Women over the age of 55 and other elderly patients are most likely to develop such symptoms, which are usually permanent.

Who Should Avoid Taking Reglan

Patients with the following conditions should not take Reglan:

  • Asthmatics
  • Patients being treated for depression
  • Patients with a history of kidney disorders
  • Anyone with elevated blood pressure
  • Parkinson's patients
  • Patients with a bleeding ulcer

Pregnant or nursing women are also advised not to take Reglan because the drug can be passed through breastfeeding. Older patients (over age 55) may also have increased risk of hip fracture after taking Reglan for more than three months, according to study published in 2004.

Alternative Medications

Doctors have also had success treating gastroparesis using a penicillin-like antibiotic known as erythromycin. Patients should also be aware that erythromycin has side effects as well and include:

  • Diarrhea
  • Nausea
  • Chest and/or stomach pain
  • Arrhythmia (irregular heartbeat)
  • Jaundice
  • Vomiting
  • Deafness (in rare cases)

    • Patients experiencing nausea and vomiting while being treated with erythromycin may find relief by using a class of motion-sickness drugs called antiemetics. If symptoms of gastroparesis are transient rather than chronic, patients can also try eating six small meals a day instead of three large ones. Another option is to take liquid nourishment until the symptoms have subsided.

    Sources

    1. DeVault, K.R. and D.O. Castell. "Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease." American Journal of Gastroenterology, vol.94 no. 6 (1999).
    2. Karlet, Mary and Linda Scheetz. Nurse Anesthesia Secrets. (Elsevier Health Sciences 2005).
    3. Shaffer, Douglas et. al. "Tardive Dyskinesia and Metoclopramide Use: Effects of Cisapride Market Withdrawal." Journal of the American Pharmacists Association vol. 44 no. 6 (2004).

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