Gangrene, ergot alkaloids causing

Uses Postpartum bleeding (uterine subinvolution) Action Ergotamine derivative Dose 0.2 mg IM after placental deliv y, may repeat 2-4-h intervals or 0.2-0.4 mg PO q6-12h for 2-7 d Caution [C, ] Contra HTN, PRO Disp Inj, tabs SE HTN, N/V Interactions t Vasoconstriction W/ ergot alkaloids, sympathomimetics, tobacco EMS Tobacco use can t vasoconstriction and lead to a hypertensive crisis OD May cause N/V/D, chest/abd pain, limb numbness, and possibly distal gangrene d/t vasoconstriction activated charcoal may be effective for PO form... 

Increased plasma concentrations cause ergot poisoning (ergotism, St Anthony s fire - dementia, florid hallucinations and persistent vasospasm gangrene may develop) and uterine muscle stimulation (it may cause abortion in pregnancy). Ergot alkaloids activates gastrointestinal serotonin receptors and central nervous system emetic centres. 

Vessels Ergot alkaloids can produce marked and prolonged a receptor-mediated vasoconstriction. An overdose can cause ischemia and gangrene of the limbs. 

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