Which statement about metoclopramide use in older adults with gastroparesis is correct?

• A. It should be avoided entirely in older adults.
• B. If used, duration should not exceed 12 weeks except in rare cases.
• C. There is no duration limit.
• D. It is preferred for long-term management.

Answer: (B)

The main concept here is safety of metoclopramide in older adults, specifically how long it should be used. Metoclopramide can cause serious movement disorders because it blocks dopamine receptors in the brain. In older adults, the risk of extrapyramidal symptoms and tardive dyskinesia is higher, and those risks increase with longer use. The Beers criteria therefore recommend using metoclopramide for gastroparesis for the shortest possible time, with a typical practical cap of about 12 weeks; longer use is generally avoided unless there are exceptional circumstances and the potential benefits clearly outweigh the risks, with close monitoring. This balance keeps symptom relief possible while minimizing irreversible movement problems.

So the statement that duration should not exceed 12 weeks except in rare cases is the best fit because it reflects the need to limit exposure to reduce serious CNS adverse effects, while still acknowledging that short-term use can be appropriate when benefits outweigh risks. The other options either overstate safety (avoid entirely), deny any duration limit, or promote long-term use, which contradicts the safety guidance for older adults.