Questions and Answers
What is the brand name of ergotamine?
Which of the following are ergotamine alkaloids? (Select all that apply)
What is the expected pharmacological action of ergotamine?
Prevent and decrease inflammation and dilation of intracranial blood vessels, thus relieve migraine pain.
What are the routes of administration for ergotamine?
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What are the routes of administration for dihydroergotamine?
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What are some side effects of ergotamine and related nursing interventions?
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What are the signs and symptoms of ergotism?
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What is the pregnancy risk category for ergotamine?
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Which of the following are contraindications for ergotamine?
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What drug class does ergotamine belong to?
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When should you take a sublingual tablet of ergotamine?
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What is the proper dosing for sublingual ergotamine?
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Study Notes
Ergotamine Overview
- Brand name for ergotamine is Ergomar.
- Common formulations include ergotamine (Ergomar), dihydroergotamine (Migranal), and a combination of ergotamine and caffeine (Cafergot).
Pharmacological Action
- Ergotamine prevents and decreases inflammation and dilation of intracranial blood vessels, effectively relieving migraine pain.
Routes of Administration
- Ergotamine can be administered via oral (PO), sublingual, or rectal routes.
- Dihydroergotamine is available through IV, IM, subcutaneous (subQ), and intranasal routes.
Adverse Effects and Nursing Interventions
- Potential adverse effects include gastrointestinal discomfort (nausea, vomiting).
- Metoclopramide (Reglan) is recommended for nausea management.
- Watch for signs of ergotism; if they occur, stop the medication and notify the physician.
- Risks of physical dependence; patients should not exceed the prescribed dose due to withdrawal symptoms like headaches and nausea.
- Pregnant women are at risk for fetal abortion with ergotamine use.
Symptoms of Ergotism
- Symptoms include muscle pain, paresthesias (tingling sensations) in fingers and toes, and cold, pale extremities.
- Vasoconstriction can lead to ischemia and potentially peripheral gangrene.
Pregnancy and Contraindications
- Ergotamine is classified as pregnancy risk category X.
- Contraindications include renal or liver disease, sepsis, hypertension, history of myocardial infarction (MI), coronary artery disease (CAD), and pregnancy.
Drug Interactions
- Concomitant use with triptans (e.g., sumatriptan, Imitrex) can lead to cardiac ischemia; they should be taken 24 hours apart.
- Some HIV protease inhibitors (e.g., ritonavir), antifungal medications (e.g., amphotericin B, ketoconazole), and macrolide antibiotics (e.g., erythromycin, azithromycin) can increase ergotamine levels and vasospasm; avoid concurrent use.
Drug Classification
- Ergotamine is classified as an alpha-adrenergic antagonist.
Sublingual Administration Guidelines
- For sublingual ergotamine, take one tablet immediately upon onset of aura or headache.
- Patients may take one sublingual tablet every 30 minutes, with a maximum of three tablets within a 24-hour period.
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Description
Test your knowledge on ergotamine with these flashcards. Covering brand names, pharmacological actions, and routes of administration, this quiz will enhance your understanding of this important drug used for migraines.
