Self-assumed Neurologic Related Condition Deviated Metoclopramide-Induced Acute Dystonic of Oculogyric Crisis in a Woman of Childbearing Age: A Case Report
A 26-year-old Malaysian woman (childbearing age) attended a private primary care clinic with a known case of gastroesophageal reflux disease (GERD) and complained of persistent nausea and a few episodes of vomiting. She had no known drug allergy, no surgical history, no hospitalization in the last t...
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Veröffentlicht in: | Journal of pharmacology & pharmacotherapeutics 2022-12, Vol.13 (4), p.396-400 |
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creator | Ismail, Nahlah Elkudssiah Jha, Ambika Nand Goh, Khang Wen Ming, Long Chiau Wahab, Mohd Shahezwan Abd Shah, Nehal J. Shah, Akshay H. Hermansyah, Andi |
description | A 26-year-old Malaysian woman (childbearing age) attended a private primary care clinic with a known case of gastroesophageal reflux disease (GERD) and complained of persistent nausea and a few episodes of vomiting. She had no known drug allergy, no surgical history, no hospitalization in the last two years, was a non-smoker, and no history of drug or alcohol abuse. The patient was prescribed Tab metoclopramide 10 mg TDS and Tab ranitidine 150 mg BD for five days. About 30 min after oral administration of both medicines, her eyes rolled involuntary upward, leading to lateral deviation of the eyes, and mouth jaws clenched as if “dislocated jaws.” The patient was immediately brought into an emergency department (ED) of a public tertiary care hospital. A drug challenge test was done which resulted in the withdrawal of metoclopramide. The accompanied sister later disclosed that the patient had taken metoclopramide and ranitidine from a private clinic earlier in the day. The patient self-assumed to have a sudden seizure, due to excessive hot weather and dehydration. A slow intravenous infusion of 50 mg/mL diphenhydramine hydrochloride in 0.9% w/v NaCl 100 mL was administered stat. Consequently, the symptoms vanished after approximately 30 min of the therapy, devoid of relapse. The patient was discharged from ED post 8 hours of monitoring with complete recovery. Physicians frequently prescribe metoclopramide to treat nausea and vomiting, which may cause adverse drug reaction of acute dystonic oculogyric crisis (OGC). Due to its unwanted and unpredictable extrapyramidal symptoms, metoclopramide should be prescribed and dispensed with caution. Thorough history taking at ED is imperative for correct early diagnosis and treatment, as metoclopramide-induced dystonic OGC has a high probability of confusion with other causes of dystonia such as conversion and seizures, encephalitis, tetanus, and hypercalcemic tetany. |
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She had no known drug allergy, no surgical history, no hospitalization in the last two years, was a non-smoker, and no history of drug or alcohol abuse. The patient was prescribed Tab metoclopramide 10 mg TDS and Tab ranitidine 150 mg BD for five days. About 30 min after oral administration of both medicines, her eyes rolled involuntary upward, leading to lateral deviation of the eyes, and mouth jaws clenched as if “dislocated jaws.” The patient was immediately brought into an emergency department (ED) of a public tertiary care hospital. A drug challenge test was done which resulted in the withdrawal of metoclopramide. The accompanied sister later disclosed that the patient had taken metoclopramide and ranitidine from a private clinic earlier in the day. The patient self-assumed to have a sudden seizure, due to excessive hot weather and dehydration. A slow intravenous infusion of 50 mg/mL diphenhydramine hydrochloride in 0.9% w/v NaCl 100 mL was administered stat. Consequently, the symptoms vanished after approximately 30 min of the therapy, devoid of relapse. The patient was discharged from ED post 8 hours of monitoring with complete recovery. Physicians frequently prescribe metoclopramide to treat nausea and vomiting, which may cause adverse drug reaction of acute dystonic oculogyric crisis (OGC). Due to its unwanted and unpredictable extrapyramidal symptoms, metoclopramide should be prescribed and dispensed with caution. Thorough history taking at ED is imperative for correct early diagnosis and treatment, as metoclopramide-induced dystonic OGC has a high probability of confusion with other causes of dystonia such as conversion and seizures, encephalitis, tetanus, and hypercalcemic tetany.</description><identifier>ISSN: 0976-500X</identifier><identifier>EISSN: 0976-5018</identifier><identifier>DOI: 10.1177/0976500X221142377</identifier><language>eng</language><publisher>New Delhi, India: SAGE Publications</publisher><subject>Alcohol abuse ; Gastroesophageal reflux</subject><ispartof>Journal of pharmacology & pharmacotherapeutics, 2022-12, Vol.13 (4), p.396-400</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c355t-1ace1b45da4cbfeac825702203878a81bdfa65fc9073126be6c8160db062842a3</citedby><cites>FETCH-LOGICAL-c355t-1ace1b45da4cbfeac825702203878a81bdfa65fc9073126be6c8160db062842a3</cites><orcidid>0000-0002-6971-1383</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0976500X221142377$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0976500X221142377$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,21973,27860,27931,27932,44952,45340</link.rule.ids></links><search><creatorcontrib>Ismail, Nahlah Elkudssiah</creatorcontrib><creatorcontrib>Jha, Ambika Nand</creatorcontrib><creatorcontrib>Goh, Khang Wen</creatorcontrib><creatorcontrib>Ming, Long Chiau</creatorcontrib><creatorcontrib>Wahab, Mohd Shahezwan Abd</creatorcontrib><creatorcontrib>Shah, Nehal J.</creatorcontrib><creatorcontrib>Shah, Akshay H.</creatorcontrib><creatorcontrib>Hermansyah, Andi</creatorcontrib><title>Self-assumed Neurologic Related Condition Deviated Metoclopramide-Induced Acute Dystonic of Oculogyric Crisis in a Woman of Childbearing Age: A Case Report</title><title>Journal of pharmacology & pharmacotherapeutics</title><description>A 26-year-old Malaysian woman (childbearing age) attended a private primary care clinic with a known case of gastroesophageal reflux disease (GERD) and complained of persistent nausea and a few episodes of vomiting. She had no known drug allergy, no surgical history, no hospitalization in the last two years, was a non-smoker, and no history of drug or alcohol abuse. The patient was prescribed Tab metoclopramide 10 mg TDS and Tab ranitidine 150 mg BD for five days. About 30 min after oral administration of both medicines, her eyes rolled involuntary upward, leading to lateral deviation of the eyes, and mouth jaws clenched as if “dislocated jaws.” The patient was immediately brought into an emergency department (ED) of a public tertiary care hospital. A drug challenge test was done which resulted in the withdrawal of metoclopramide. The accompanied sister later disclosed that the patient had taken metoclopramide and ranitidine from a private clinic earlier in the day. The patient self-assumed to have a sudden seizure, due to excessive hot weather and dehydration. A slow intravenous infusion of 50 mg/mL diphenhydramine hydrochloride in 0.9% w/v NaCl 100 mL was administered stat. Consequently, the symptoms vanished after approximately 30 min of the therapy, devoid of relapse. The patient was discharged from ED post 8 hours of monitoring with complete recovery. Physicians frequently prescribe metoclopramide to treat nausea and vomiting, which may cause adverse drug reaction of acute dystonic oculogyric crisis (OGC). Due to its unwanted and unpredictable extrapyramidal symptoms, metoclopramide should be prescribed and dispensed with caution. Thorough history taking at ED is imperative for correct early diagnosis and treatment, as metoclopramide-induced dystonic OGC has a high probability of confusion with other causes of dystonia such as conversion and seizures, encephalitis, tetanus, and hypercalcemic tetany.</description><subject>Alcohol abuse</subject><subject>Gastroesophageal reflux</subject><issn>0976-500X</issn><issn>0976-5018</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp1UdtKw0AQDaJgqf0A3xZ8Tt1LLhvfQuqlUBW8YN_CZjOJW5Js3E2Efos_69aKPojzMjNn5pwDM553SvCckDg-x0kchRivKSUkoCyOD7zJDvNDTPjhT43Xx97M2g12wZIAB8nE-3iEpvKFtWMLJbqD0ehG10qiB2jE4KBMd6UalO7QAt7VF3QLg5aN7o1oVQn-sitH6eBUjgOgxdYOunMCukL3cnRiW-O6zCirLFIdEuhFt6LbzbNX1ZQFCKO6GqU1XKAUZcKCM--1GU68o0o0Fmbfeeo9X10-ZTf-6v56maUrX7IwHHwiJJAiCEsRyKICITkNY0wpZjzmgpOirEQUVjLBMSM0KiCSnES4LHBEeUAFm3pne93e6LcR7JBv9Gg6Z5kzHDF31JBTt0X2W9Joaw1UeW9UK8w2JzjfvSH_8wbHme85VtTwq_o_4RMFUoi3</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Ismail, Nahlah Elkudssiah</creator><creator>Jha, Ambika Nand</creator><creator>Goh, Khang Wen</creator><creator>Ming, Long Chiau</creator><creator>Wahab, Mohd Shahezwan Abd</creator><creator>Shah, Nehal J.</creator><creator>Shah, Akshay H.</creator><creator>Hermansyah, Andi</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0002-6971-1383</orcidid></search><sort><creationdate>202212</creationdate><title>Self-assumed Neurologic Related Condition Deviated Metoclopramide-Induced Acute Dystonic of Oculogyric Crisis in a Woman of Childbearing Age: A Case Report</title><author>Ismail, Nahlah Elkudssiah ; Jha, Ambika Nand ; Goh, Khang Wen ; Ming, Long Chiau ; Wahab, Mohd Shahezwan Abd ; Shah, Nehal J. ; Shah, Akshay H. ; Hermansyah, Andi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c355t-1ace1b45da4cbfeac825702203878a81bdfa65fc9073126be6c8160db062842a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Alcohol abuse</topic><topic>Gastroesophageal reflux</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ismail, Nahlah Elkudssiah</creatorcontrib><creatorcontrib>Jha, Ambika Nand</creatorcontrib><creatorcontrib>Goh, Khang Wen</creatorcontrib><creatorcontrib>Ming, Long Chiau</creatorcontrib><creatorcontrib>Wahab, Mohd Shahezwan Abd</creatorcontrib><creatorcontrib>Shah, Nehal J.</creatorcontrib><creatorcontrib>Shah, Akshay H.</creatorcontrib><creatorcontrib>Hermansyah, Andi</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Journal of pharmacology & pharmacotherapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ismail, Nahlah Elkudssiah</au><au>Jha, Ambika Nand</au><au>Goh, Khang Wen</au><au>Ming, Long Chiau</au><au>Wahab, Mohd Shahezwan Abd</au><au>Shah, Nehal J.</au><au>Shah, Akshay H.</au><au>Hermansyah, Andi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Self-assumed Neurologic Related Condition Deviated Metoclopramide-Induced Acute Dystonic of Oculogyric Crisis in a Woman of Childbearing Age: A Case Report</atitle><jtitle>Journal of pharmacology & pharmacotherapeutics</jtitle><date>2022-12</date><risdate>2022</risdate><volume>13</volume><issue>4</issue><spage>396</spage><epage>400</epage><pages>396-400</pages><issn>0976-500X</issn><eissn>0976-5018</eissn><abstract>A 26-year-old Malaysian woman (childbearing age) attended a private primary care clinic with a known case of gastroesophageal reflux disease (GERD) and complained of persistent nausea and a few episodes of vomiting. 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Consequently, the symptoms vanished after approximately 30 min of the therapy, devoid of relapse. The patient was discharged from ED post 8 hours of monitoring with complete recovery. Physicians frequently prescribe metoclopramide to treat nausea and vomiting, which may cause adverse drug reaction of acute dystonic oculogyric crisis (OGC). Due to its unwanted and unpredictable extrapyramidal symptoms, metoclopramide should be prescribed and dispensed with caution. Thorough history taking at ED is imperative for correct early diagnosis and treatment, as metoclopramide-induced dystonic OGC has a high probability of confusion with other causes of dystonia such as conversion and seizures, encephalitis, tetanus, and hypercalcemic tetany.</abstract><cop>New Delhi, India</cop><pub>SAGE Publications</pub><doi>10.1177/0976500X221142377</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-6971-1383</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Alcohol abuse Gastroesophageal reflux |
title | Self-assumed Neurologic Related Condition Deviated Metoclopramide-Induced Acute Dystonic of Oculogyric Crisis in a Woman of Childbearing Age: A Case Report |
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