Which direct acting cholinergic is used to control vomiting and promote gastric emptying? Trade Reglan.

• A. Metoclopramide
• B. Ranitidine
• C. Ondansetron
• D. Cisapride

Answer: (A)

Metoclopramide (Reglan) is used because it combines antiemetic effects with prokinetic action to promote gastric emptying. It works centrally by blocking dopamine D2 receptors in the brain’s emetic center, reducing vomiting, and peripherally it enhances cholinergic activity in the gut—via 5-HT4 receptor stimulation that increases acetylcholine release in the upper GI tract. This boost in acetylcholine speeds gastric motility and improves emptying, which helps symptoms like gastroparesis and reflux. The other drugs listed do not provide both antiemetic control and gastric emptying in the same way: some are antiemetics without prokinetic effects, and others are prokinetics with different mechanisms. Reglan is the classic agent used for vomiting control plus accelerated gastric emptying.