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Notas do Editor
- Dopamine antagonist with central and peripheral effects- It blocks dopamine receptors, which normally mediate an inhibitory effect on the smooth muscle of the GI tract. The inhibition of dopamine and augmentation of acetylcholine release sensitizes the muscarinic receptors of the GI tract smooth muscle, resulting in coordinated intestinal contractiuons. Also has both direct and indirect effects on cholinergic receptors Accelerates gastric emptying in normal and diseased states. May shorten the duration of ileus The efficacy has been far from consistent and long term there is a tendency toward tolerance Dose adjustments are necessary in renal failure Side effects are higher at higher doses and the extremes of age Include anxiety, nervousness, insomnia. Also, confusion, hallucinations, and dystonic reactions Gynecomastia occurs secondary to enhanced release of prolactin. Domperidone is another dopamine antagonist that does not cross the blood-brain barrier available throughout the world but not yet available in the US