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Slower infusion of metoclopramide decreases the rate of akathisia.
Am J Emerg Med. 2009 May; 27(4):475-80.AJ

Abstract

OBJECTIVE

We investigated the difference in incidence of acute akathisia related to the rate of infusion in patients receiving metoclopramide for acute nausea, vomiting, or migraine headache in the emergency department (ED).

METHODS

Randomized, prospective, double-blind clinical trial of patients aged 18 years and older who were to receive intravenous metoclopramide for the treatment of nausea, vomiting, or headache were eligible. Patients were excluded if they were taking medications that might mimic or mask akathisia, had a movement disorder, renal insufficiency, or were unable or unwilling to consent. Pregnant women and prisoners were also excluded. Subjects were randomized to receive 1 of 2 accepted metoclopramide administration regimens. The regimens included 10 mg of metoclopramide administered either as a 2-minute bolus (BG) or as a slow infusion for 15 minutes (IG). All patients received a normal saline placebo at the opposite rate to maintain blinding. The main outcome was development of akathisia noted at 60 minutes after drug administration as measured either with The Prince Henry Hospital akathisia rating scale or by sudden unexplained departure from the ED during treatment.

RESULTS

One hundred twenty-seven patients were eligible for the study. Fifty-nine patients met exclusion criteria. Of the remaining 68 patients, 36 were randomized to the BG and 32 were randomized to the IG. In the BG, 11.1% of patients developed akathisia compared with 0% in the IG (P = .026). Four patients developed akathisia based on the scale and 2 departed suddenly from the ED.

CONCLUSIONS

Slower infusion of metoclopramide reduces the incidence of akathisia.

Authors+Show Affiliations

Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. lregan@jhmi.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19555621

Citation

Regan, Linda A., et al. "Slower Infusion of Metoclopramide Decreases the Rate of Akathisia." The American Journal of Emergency Medicine, vol. 27, no. 4, 2009, pp. 475-80.
Regan LA, Hoffman RS, Nelson LS. Slower infusion of metoclopramide decreases the rate of akathisia. Am J Emerg Med. 2009;27(4):475-80.
Regan, L. A., Hoffman, R. S., & Nelson, L. S. (2009). Slower infusion of metoclopramide decreases the rate of akathisia. The American Journal of Emergency Medicine, 27(4), 475-80. https://doi.org/10.1016/j.ajem.2008.03.044
Regan LA, Hoffman RS, Nelson LS. Slower Infusion of Metoclopramide Decreases the Rate of Akathisia. Am J Emerg Med. 2009;27(4):475-80. PubMed PMID: 19555621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Slower infusion of metoclopramide decreases the rate of akathisia. AU - Regan,Linda A, AU - Hoffman,Robert S, AU - Nelson,Lewis S, PY - 2008/03/05/received PY - 2008/03/31/accepted PY - 2009/6/27/entrez PY - 2009/6/27/pubmed PY - 2009/7/22/medline SP - 475 EP - 80 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 27 IS - 4 N2 - OBJECTIVE: We investigated the difference in incidence of acute akathisia related to the rate of infusion in patients receiving metoclopramide for acute nausea, vomiting, or migraine headache in the emergency department (ED). METHODS: Randomized, prospective, double-blind clinical trial of patients aged 18 years and older who were to receive intravenous metoclopramide for the treatment of nausea, vomiting, or headache were eligible. Patients were excluded if they were taking medications that might mimic or mask akathisia, had a movement disorder, renal insufficiency, or were unable or unwilling to consent. Pregnant women and prisoners were also excluded. Subjects were randomized to receive 1 of 2 accepted metoclopramide administration regimens. The regimens included 10 mg of metoclopramide administered either as a 2-minute bolus (BG) or as a slow infusion for 15 minutes (IG). All patients received a normal saline placebo at the opposite rate to maintain blinding. The main outcome was development of akathisia noted at 60 minutes after drug administration as measured either with The Prince Henry Hospital akathisia rating scale or by sudden unexplained departure from the ED during treatment. RESULTS: One hundred twenty-seven patients were eligible for the study. Fifty-nine patients met exclusion criteria. Of the remaining 68 patients, 36 were randomized to the BG and 32 were randomized to the IG. In the BG, 11.1% of patients developed akathisia compared with 0% in the IG (P = .026). Four patients developed akathisia based on the scale and 2 departed suddenly from the ED. CONCLUSIONS: Slower infusion of metoclopramide reduces the incidence of akathisia. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/19555621/Slower_infusion_of_metoclopramide_decreases_the_rate_of_akathisia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(08)00277-5 DB - PRIME DP - Unbound Medicine ER -