V2ii: Ergotamine

Ergotamine

Ergotamine

Chemical

Ergot alkaloid

Use

PPH

Cluster headaches

Migraines

Presentation

Tablets

Vial

Also comes in combination with oxytocin (Syntometrine = 0.5mg ergometrine and 5IU oxytocin)

Dose

Single 250mcg IM dose in first line Mx of PPH due to uterine atony

IV – administer 25-50mcg boluses q3mins up to total 250mcg

Route

IM/IV

Onset

6-7mins IM

DoA

2-4hrs

MoA

Acts directly on uterine smooth muscle to increase tone, rate and amplitude of tetanic contraction

a1/5HT receptor agonist

PD

Vasculature: powerful vasoconstriction

PK

A

D

NA

M

Hepatic metabolism by undefined pathways

E

T1/2b 2hrs

Adverse Effects

N+V

HTN

Abdominal pain

C/I

HTN, IHD, Retained placenta/pre-eclapmsia/eclampsia