Bromopride
Bromopride is a dopamine antagonist used as an antiemetic. Its prokinetic properties are similar to those of metoclopramide.
Mechanism of effect
Dopamine D2 receptor Antagonist :Drug that bind to but do not activate DOPAMINE RECEPTORS, thereby blocking the actions of dopamine or exogenous agonists
Pharmacokinetics
Protein binding
40%.
Metabolism
Hepatic.
Clearance
Renal, 10-14% as original compound.
Drug indications
GI motility disorders;
Nausea and vomiting
Dosage
PO : 20-60 mg daily in divided doses
IV/IM: 20 mg daily.
Drug contraindications
intestinal obstruction , PheochromocytomaGI haemorrhage, obstruction, perforation or immediately after surgery. Patients with pheochromocytoma.
Side effects
parkinson , depression , High Blood Pressure , Headache , vertigo , Diarrhea , extrapyramidal effects , difficulty urinating , RestlessnessExtrapyramidal symptoms; restlessness, drowsiness, diarrhoea; hypotension, hypertension, dizziness, headache, depression; galactorrhoea , Neuroleptic malignant syndrome, Parkinsonism , tardive dyskinesia
Interactions
Doxepin , Citalopram , Butalbital and Acetaminophen , Quazepam , Cariprazine , Opium , Aripiprazole , Bromocriptine , Pramipexole , Tetrabenazine , Dihydroergotamine , Ropinirole , Sulpiride , Piribedil , dopexamine , Dihydroergocornine , Benzatropine , Rotigotine , Deutetrabenazine , Brexpiprazole , lisuride , Quinagolide , Cabergoline , Levodopa , lithium , Apomorphine , Pergolide , Fenoldopam , Ethchlorvynol , ethotoinAlerts
- should be used with caution in Children, young patients, elderly;renal impairment,epilepsy, Parkinson's disease; history of depression.
-May impair ability to drive or operate machinery.
- Increased toxicity may occur if it is given to patients receiving lithium, and caution is advisable with other centrally active drugs such as antiepileptics.
Points of recommendation
-Transient increase in plasma-aldosterone concentration.
-should be used with caution in patients taking other drugs that can also cause extrapyramidal reactions, such as the phenothiazines.
-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
- stimulates prolactin secretion and may cause galactorrhoea or related disorders.
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