PURPOSE: Discontinuation of offending drugs can prevent drug-induced parkinsonism (DIP) before it occurs and reverse or cure it afterwards. The aim of this study was to investigate the prevalence of DIP and the utilization of offending drugs through an analysis of representative nationwide claims data. MATERIALS AND METHODS: We selected DIP patients of ages ranging from 40 to 100 years old with the G21.1 code from the Korean National Service Health Insurance Claims database from 2009 to 2015. The annual standardized prevalence of DIP was explored from 2009 to 2015. Trends were estimated using the compound annual growth rate (CAGR) and the Cochran-Armitage test for DIP over the course of 6 years. Additionally, the utilization of offending drugs was analyzed. RESULTS: The annual prevalence of DIP was 4.09 per 100000 people in 2009 and 7.02 in 2015 (CAGR: 9.42%, p<0.001). Levosulpiride use before and after DIP diagnosis showed a clear trend for decreasing utilization (CAGR: −5.4%, −4.3% respectively), whereas the CAGR for itopride and metoclopramide increased by 12.7% and 6.4%, respectively. In 2015, approximately 46.6% (858/1840 persons) of DIP patients were prescribed offending drugs after DIP diagnosis. The most commonly prescribed causative drug after DIP diagnosis was levosulpiride. CONCLUSION: The prevalence of DIP has increased. To prevent or decrease DIP, we suggest that physicians reduce prescriptions of benzamide derivatives that have been most commonly used, and that attempts be made to find other alternative drugs. Additionally, the need for continuing education about offending drugs should be emphasized.
Diagnosis ; Education, Continuing ; Humans ; Insurance, Health ; Korea ; Metoclopramide ; Parkinson Disease ; Parkinsonian Disorders ; Prescriptions ; Prevalence

No abstract available.
Hemorrhage ; Metoclopramide

No abstract available.
Disorders of Excessive Somnolence ; Humans ; Metoclopramide ; Parkinsonian Disorders

Hiccup is an intermittent, involuntary and erratic contraction of the diaphragm, immediately followed by a laryngeal closure. Persistent and intractable hiccups are rare but severe, keeping a person from doing daily activities; these can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration. Therefore, proper treatments are necessary. We present a case with intractable hiccup treated with an unusual treatment. A 61-year-old man presented with intractable hiccups, which started 6 years ago after subarachnoid and intraventricular hemorrhage. Conventional pharmacologic treatments including metoclopramide, gabapentin, and baclofen were unsuccessful. Cooperating with cardiothoracic surgeons, phrenic nerve clipping operation was done under intraoperative electrophysiologic monitoring. This method was successful that the symptoms were relieved. Reversible clipping done under intraoperative electrophysiologic monitoring can be a promising therapeutic method for persistent and intractable hiccups in patients with stroke.
Baclofen ; Dehydration ; Depression ; Diaphragm ; Electromyography ; Fatigue ; Hemorrhage ; Hiccup* ; Humans ; Malnutrition ; Methods ; Metoclopramide ; Middle Aged ; Phrenic Nerve* ; Stroke* ; Surgeons ; Weight Loss

Orofacial dyskinesia is a condition caused by various diseases in which the tongue, lips, or jaws move involuntarily. Up to now, the exact mechanism for these degenerative changes in the brain remains unknown. Among various hypotheses, the most widely accepted hypothesis is that orofacial dyskinesia is caused by supersensitivity of the dopamine receptors. As a result, metoclopramide, a dopaminergic receptor blocking agent has been chosen as a treatment agent for our study. We used metoclopramide in seven stroke patients who displayed symptoms of orofacial dyskinesia following brain damage and observed an improvement in the symptoms from all patients. This case report represented new therapeutic methods and will aid in the treatment of orofacial dyskinesia.
Brain ; Dopamine ; Dyskinesias ; Humans ; Jaw ; Lip ; Metoclopramide* ; Movement Disorders* ; Receptors, Dopamine ; Stroke* ; Tongue

We report a unique case of intestinal duplication detected on posterior reversible encephalopathy syndrome (PRES) in a 13-year-old girl. She was admitted to the pediatric Emergency Department because of generalized seizures. Radiological assessment revealed a large, well-defined, thick-walled cystic lesion in the mid abdomen, suggestive of duplication cyst associated to a PRES. Exploration confirmed the diagnosis of ileal duplication cyst, and the mass was resected. The postoperative course was uneventful. Both hypertension and neurological dysfunction resolved after the mass resection. A followup brain magnetic resonance imaging was performed 9 months later and showed complete resolution of the cerebellar changes. Although extrinsic compression of the retroperitoneal structures has not been reported in the literature as a complication of duplication cyst, we strongly believe that this is the most logical and plausible hypothesis that would explain the pathogenesis of PRES in our patient.
Abdomen ; Adolescent ; Brain ; Diagnosis ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Ileum ; Logic ; Magnetic Resonance Imaging ; Metoclopramide ; Posterior Leukoencephalopathy Syndrome* ; Seizures

BACKGROUND: This prospective randomized double-blinded study was designed to compare the efficacy of a combination of high dose metoclopramide and dexamethasone with that of haloperidol, midazolam and dexamethasone, for the prevention of postoperative nausea and vomiting (PONV) in patients scheduled for laparoscopic gynecologic surgery who are receiving fentanyl intravenous-patient controlled analgesia. METHODS: The subjects were randomly allocated to either group M (20 mg metoclopramide and 10 mg dexamethasone was administered at induction, n = 35) or group H (1 mg haloperidol, 3 mg midazolam and 10 mg dexamethasone were administered at induction, n = 35). The incidence of PONV and the severity (measured by numeric rating scale) of the patients' nausea and pain were evaluated at 6 hours, 24 hours, and 48 hours, postoperatively. RESULTS: The overall incidence of the PONV was not significantly different between the two groups during the 48 hours period (group M: 21% vs. group H: 12%). The severity of the nausea and pain were similar between the two groups. CONCLUSIONS: The prophylactic use of a combination of 1 mg haloperidol, 3 mg midazolam and 10 mg dexamethasone is as effective and inexpensive as 20 mg metoclopramide and 10 mg dexamethasone to prevent PONV.
Analgesia ; Dexamethasone* ; Female ; Fentanyl ; Gynecologic Surgical Procedures* ; Haloperidol* ; Humans ; Incidence ; Metoclopramide* ; Midazolam* ; Nausea ; Postoperative Nausea and Vomiting* ; Prospective Studies

BACKGROUND: The patients receiving hematopoietic stem cell transplantation (HSCT) are known to have a high incidence of breakthrough nausea and vomiting due to the conditioning regimen. The purpose of this study was to evaluate the adequacy of antiemetic therapy for breakthrough nausea and vomiting in patients receiving HSCT and to propose an effective treatment regimen. METHODS: We retrospectively reviewed the electronic medical records of 109 adult patients. The collected data were used to identify (1) antiemetic and dosing regimens prescribed for controlling breakthrough nausea and vomiting, (2) the rate of patients who developed breakthrough nausea and vomiting, and (3) the percent of antiemetics prescribed on the day of symptom onset. Based on the National Comprehensive Cancer Network guideline, we assessed the suitability of antiemetics for breakthrough nausea and vomiting, and prescription timing. RESULTS: All patients were prescribed pro re nata antiemetics. About 40.0%, 41.4%, and 18.6% of patients were using one, two, and three or more additional drugs for breakthrough nausea and vomiting, respectively. The most frequently administered drugs were intravenous metoclopramide (43.8%) and granisetron patch (36.2%). Breakthrough nausea and vomiting occurred in 87 patients (79.1%) and they developed symptoms 320 cases. About 220 cases (68.8%) were treated with additional antiemetics on the day of symptom onset and the rate of symptom resolution was only 10.3% (9 patients). CONCLUSION: The breakthrough nausea and vomiting in patients receiving HSCT occurred very frequently and was hard to control, thus requiring more rapid and aggressive treatments.
Adult ; Antiemetics ; Electronic Health Records ; Granisetron ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Incidence ; Metoclopramide ; Nausea* ; Prescriptions ; Retrospective Studies ; Vomiting*

BACKGROUND/AIMS: Prokinetic drugs such as metoclopramide are frequently used as second-line therapy for patients with gastroesophageal reflux disease. However, their beneficial effects remain unclear. Esophageal motor activities and compliance of the esophagogastric junction (EGJ) are important for prevention of gastroesophageal reflux. Although metoclopramide has been reported to increase lower esophageal sphincter (LES) pressure, its effects on EGJ compliance have not been evaluated. In the present study, we investigated the effects of metoclopramide on esophageal motor activities and EGJ compliance. METHODS: Nine healthy male volunteers without abdominal symptoms were enrolled. Peristaltic esophageal contractions and LES pressure were examined using high-resolution esophageal manometry, while EGJ compliance was evaluated with an endoluminal functional lumen-imaging probe. After obtaining baseline values for esophageal motor activities and EGJ compliance, metoclopramide (10 mg) was intravenously administered, then all measurements were repeated at 15 minutes after administration in each subject. RESULTS: Following administration of metoclopramide, mean resting LES pressure was significantly increased as compared with the baseline (13.7 +/- 9.2 vs 26.7 +/- 8.8 mmHg, P < 0.05). In addition, metoclopramide significantly augmented peristaltic contractions, especially in the distal esophageal segment (P < 0.05). On the other hand, distensibility index did not change after administration (4.5 +/- 0.5 vs 4.1 +/- 0.5 mm2/mmHg), suggesting no significant effect of metoclopramide on EGJ compliance. CONCLUSIONS: Metoclopramide augmented esophageal contractions without changing EGJ compliance in healthy adults.
Adult ; Compliance* ; Esophageal Sphincter, Lower ; Esophagogastric Junction* ; Gastroesophageal Reflux ; Hand ; Healthy Volunteers* ; Humans ; Male ; Manometry ; Metoclopramide* ; Motor Activity* ; Volunteers

OBJECTIVETo observe the differences in clinical effect on menstrual migraine between subgaleal acupoint injection with metoclopramide and oral administration of medication.

METHODSSixty-four patients of menstrual migraine were randomized into a subgaleal acupoint injection group and a medication group, 32 cases in each one. In the subgaleal acupoint injection group, the acupoint injection started 10 days before menstruation. Eight acupoints on the head were selected and injected alternatively in two groups, once every 2 days, 4 treatments made one session and 3 sessions (3 menstrual cycles) were required. In the medication group, flunarizine was applied with oral administration, 2.5 mg each time, once every night. The duration of treatment was 3 months. The analgesic effect, frequency and time of pain attack were observed in 3 and 6 months after treatment in the two groups.

RESULTSAfter treatment, VAS scores were lower than those before treatment in the two groups (P<0.01, P<0.05), the attack frequency and pain time were all reduced as compared with those before treatment (all P<0.01). After treatment, VAS score, the frequency and time of pain attack in the subgaleal acupoint injection group were improved significantly as compared with the medication group (all P<0.01).

CONCLUSIONThe subgaleal acupoint injection with metoclopramide achieves the superior preventive effect in clinical treatment of menstrual migraine as compared with flunarizine.

Acupuncture Points ; Adolescent ; Adult ; Female ; Humans ; Menstruation ; drug effects ; Metoclopramide ; administration & dosage ; Migraine Disorders ; drug therapy ; physiopathology ; prevention & control ; Young Adult