Background Due to the incidence of adverse anticholinergic and antidopaminergic effects caused by metoclopramide in 65-year-old patients, we decided to study its prescription.
Purpose To study the adequacy of intravenous and oral metoclopramide prescriptions to the EU-7 (PIM) list, published by the European Journal of Clinical Pharmacy in May 2015, in which a list, by seven experts in this matter, of inappropriate medicines for older patients was included.
To evaluate the efficacy of metoclopramide at the recommended doses.
Material and methods Crossed study of intravenous and oral metoclopramide, performed on 9 September 2015, in all inpatients >65 years old who were treated with intravenous and oral metoclopramide, and who had renal function evaluation by creatinine clearance.
Results 72 of 197 inpatients studied had been prescribed metoclopramide as propulsive treatment. 70.8% had creatinine clearance <60 mg/dL, and 40.1% <40 mg/dL.
Of those inpatients treated with metoclopramide, 69% were prescribed 10 mg every 8 h intravenously, 20.8% were prescribed 10 mg every 8 h orally and only 10.2% were prescribed according to the EU-7 (PIM) of 10 mg every 12 h orally and 5 mg every 8 h orally.
Conclusion It is vital that doctors, pharmacists and health professionals keep training and acquiring knowledge about chronic patients to avoid inappropriate prescriptions. In our case, 89.8% of those >65 years of age were receiving a higher dose than recommended.
Pharmacists’ interventions should be higher in metoclopramide prescriptions for elder patients so that adverse anticholinergic and antidopaminergic effects can be avoided.
Cooperation and integration of the pharmacist into the multidisciplinary team would help to decrease these adverse effects.
Correct training of health professionals regarding chronic patients receiving multiple medicines would avoid inappropriate adverse effects. In all patients, the doses recommended by EU-7 (PIM) were effective.
References and/or Acknowledgements
Renom A, Meyer G. The EU (7)-PIM: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacy 2015
Schubert I, Kupper-Nybelen J, Ihle P, Thürmann P. Prescribing potentially inappropriate medication (PIM) in Germany´s elderly as indicated by the PRISCUS list. An analysis based on regional claims data. Pharmacoepidemiology and Drug Safety 2013; 22:719-727
References and/or AcknowledgementsNo conflict of interest.
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