European Journal of Biomedical and Pharmaceutical Sciences

METOCLOPRAMIDE INJECTION- INDUCED UNCONTROLLABLE MOVEMENTS (EXTRA PYRAMIDAL SYMPTOMS): A CASE REPORT

D. Lalitha Rani and V. Sri. Venkateswara Rao*

ABSTRACT

A 21 year old male patient was suffering with chills, high fever and vomitings. He was accompanied by his father and consulted the physician. After thorough examination, the physician asked the patient for blood tests which revealed that he was malarial positive. His vitals are slightly higher than the normal. He was put on the following drugs immediately: Chloroquine phosphate injection (250mg/2 ml), Metclopramide injection (Metoclopramide 5 mg/ml), and Paracetamol tablet (500mg). After 20 minutes, the patient started complaining of uncontrollable movements of neck and head. The abnormal movement of head and neck was noticed from right side to left side. The physician has recognized the side effect that it was due to metclopramide injection and he has administered diazepam injection (5 mg/ml). The patient has completely recovered from the drug induced uncontrollable movements after 15 minutes. Hence there is a vital need for therapeutic drug monitoring system in health care units before and after administration of drugs to the patient so that, we can achieve better health out come and patient satisfaction.

Keywords: Malaria, Anopheles, Plasmodium, Chloroquine phosphate, Metclopramide, Paracetamol, Diazepam, Uncontrollable movements, Dystonia, Akathisia Tardive dyskinesia, Therapeutic drug monitoring.