From the presented symptoms of the patient, it can be concluded that the patient suffers from gastroparesis, where the stomach takes too much time to empty its contents. The prolonged gastric emptying duration can be accountable for feelings of compactness, bloating, and nausea. The pharmacological management plan for the patient must be carefully considered due to her age and comorbidities. The class of drugs used to handle gastroparesis is prokinetic agents, increasing gastric motility and hastening gastric emptying. One of the used prokinetic agents is metoclopramide, which maximizes the release of acetylcholine and refines the gut to its effects (Giudicessi et al., 2018). More prokinetic agents are erythromycin, demperidone, and cisapride, where cisapride is associated with severe cardiac adverse impacts and is unavailable in most countries. Metoclopramide is appropriate for the patient in the case study, beginning at a low dose and titrating up as tolerated. The patient’s symptoms must be monitored closely, with the medication used for the shortest time possible. Additionally, the patient’s blood glucose levels require close monitoring because the drug can increase insulin production, causing hypoglycemia in diabetic patients, and the pharmacologic management plan for the gastroparesis patient entails using prokinetic agents, like metoclopramide to enhance motility and hasten gastric emptying. Due to the patient’s age, the medication must be used cautiously, monitoring potential adverse effects closely.
The pharmacologic management plan for gastroparesis must be considered the patient’s symptoms and radiographic gastric emptying study. One approved alternative is using prokinetic agents like metoclopramide, increasing gastrointestinal motility, obstructing dopamine receptors in the brain and animating tissues to acetylcholine (Shakhatreh et al., 2019). This medication can minimize symptoms like nausea, vomiting, and bloating, and the drug also has potential side effects like tardive dyskinesia, an irreparable movement disease, and parkinsonism-such symptoms, specifically in elderly patients. The use of metoclopramide must be avoided in patients having a history of gastrointestinal blockage, bleeding, and perforation (Gök et al., 2019). The medicine’s profile and dosage must be attentively monitored in patients with renal and hepatic impairment, where a lower dose must be directed. The patient’s declining renal function is outlined, her creatinine clearance must be evaluated before initiating metoclopramide therapy. The hazards and profits of the drug should be thoroughly discussed with the patient before beginning any treatment.
A patient with symptoms like nausea, belatedness, fatigue, and reduced renal function having a history of type II diabetes may have gastroparesis. A radiographic gastric emptying study verifies the diagnosis. The pharmacologic management plan for gastropareses involves prokinetic agents like metoclopramide, enhancing gastric emptying by maximizing the tone and contractility of the stomach muscles. Metoclopramide has potential contradictions like extrapyramidal symptoms, tardive dyskinesia, and interactions with other medications. Accurate monitoring of the patient’s response and side effects is appropriate, ensuring effective treatment and reducing adverse reactions.
Chivese, T., Hirst, J., Matizanadzo, J. T., Custodio, M., Farmer, A., Norris, S., & Levitt, N. (2022). The diagnostic accuracy of HbA1c, compared to the oral glucose tolerance test, for screening for type 2 diabetes mellitus in Africa—A systematic review and meta‐analysis. Diabetic Medicine, 39(4), e14754. https://doi.org/10.1111/dme.14754
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