BT_GS 1.44 describe the clinical pharmacology of drugs used in management of PONV


I’m not a fan of Maxolon. This is a bit of an understatement actually. The main thing that bugs me about its still prevalent use in Australian hospitals is that it doesn’t actually work!! That is because it is not prescribed at a dose which is efficacious. The effective dose of metoclopramide for the treatment of PONV is 0.5mg/ kg. Consequently 10mg given to a 100kg patient is unlikely to help the cause. You may provoke an acute dystonic reaction if you’re unlucky. You may also provoke a raging tachycardia as the plastic ampoules look very similar to those of atropine (particularly when they were both in black print unlike the photo above). Since ondansetron is actually cheaper than Maxolon in my hospital I can think of no circumstances in which I would prescribe it.

Regarding metoclopramide:

It is not recommended by SAMBA* for the prevention or treatment of PONV T/F

The Australian TGA recommends a maximum dose in adults of 10mg three times a day. T/F

Despite avidly crossing the placenta, metoclopramide is the only antiemetic agent with a Category A rating for use in pregnancy T/F

Metoclopramide’s pro kinetic actions are negligible in the presence of anticholinergic therapy T/F

Metoclopramide may stimulate the secretion of prolactin and prolong the duration of sux T/F


Look in Stoelting if you’re not sure about the last one.

*You should know who SAMBA are- they’re not latin dance fans either.