dosage form for this use. The usual dose of the nasal spray dosage form is one spray
in each nostril two to three minutes before nursing. Side effects associated with the use
of oxytocin include increased blood pressure, nausea and vomiting, and labored
b. Ergonovine Maleate (Ergotrate). Ergonovine maleate is used to control
postpartum hemorrhage. It is not used to induce labor. The dosage of this product is
adjusted based on the uterine responses. Ergonovine maleate is supplied in both
injection and tablet dosage forms. Side effects associated with this agent include
increased blood pressure, nausea and vomiting, and labored breathing. Both the tablet
and injection dosage forms are used on an inpatient basis; however, on rare occasions
the tablets may be dispensed for outpatient use.
c. Methylergonovine Maleate (Methergine). Methylergonovine maleate is
used to control postpartum hemorrhage and to prevent uterine atony. It is supplied in
both injection and tablet dosage forms. The usual dosage for the injection is 0.2
milligram every two to four hours as needed. The usual dosage for the tablet is one
tablet three or four times daily for a maximum of one week during puerperium. (NOTE:
Puerperium is the period of hospital confinement after a woman has given birth to the
child.) The side effects associated with this agent include increased blood pressure,
nausea, vomiting, and labored breathing.
Section II. ERGOT ALKALOIDS
Ergot alkaloids are agents which are derivatives of Claviceps purpurea, the ergot
fungus. This fungus naturally attacks wheat and rye. Some of the effects of ergot
alkaloids were discovered when grain with the ergot fungus was ingested by people
many years ago. Specifically, some persons who ate the contaminated grain developed
gangrene due to the vasoconstriction caused by the ergot alkaloids. Furthermore,
pregnant women who ate the contaminated grain aborted the fetuses because the ergot
alkaloids produce effects similar to oxytocin (i.e., uterine contractions).
11-10. USES OF THE ERGOT ALKALOIDS
Ergot alkaloids are mainly used in the management of migraine headaches, but
they can also be used to control postpartum hemorrhage.
The primary problem associated with ergot alkaloids is the possibility of the
patient suffering from ergotism. Ergotism is an intoxication or poisoning due to an
overdose of the ergot alkaloids. Ergotism is characterized by hot and cold sensations in
the hands and feet (sometimes called St. Anthony's Fire), numbness, tingling,