The use of metoclopramide in ileus: A look at duration of therapy

Purpose: The authors conducted a retrospective chart review to determine if metoclopramide was being used properly for ileus and if it caused any adverse effects. Methods: All adult patients admitted to the institution's ICUs between November 10, 2000 and January 31, 2001 were evaluated for enrollment. Data was obtained from medication administration records, patient flow sheets, the computer-based laboratory and report systems, and a database of adverse drug events. Bowel movements were used to assess effectiveness. The primary endpoint was the length of time metoclopramide was continued after the first bowel movement. A secondary endpoint was the occurrence of any adverse effects related to metoclopramide administration. Results: There were a total of 32 patients who received metoclopramide for ileus during the time period studied. The average number of days people received metoclopramide was 11.5 ± 7.3 days. The mean time to first bowel movement was 1.7 ± 1.4 days. Patients had therapy continued after first bowel movement for an average of 10.7 ± 7.1 days. Extrapyramidal symptoms possibly occurred in 3% of the patients. Conclusion: The results suggest that metoclopramide was used for the treatment of ileus in ICU patients for prolonged periods of time. This overuse may place patients at risk for adverse events and may also occur at other institutions.