14. ERGOT ALKALOIDS
DRUG NAME methylergonovine (Methergine)
CLASS Ergot derivative, oxytocic
MECHANISM OF
ACTION
Acts primarily on alpha-adrenergic receptors on uterine and vascular smooth muscle,
increasing uterine tone and causing vasoconstriction
INDICATIONS Postpartum hemorrhage, uterine atony / subinvolution
ROA IM, IV, PO
SIDE EFFECTS
•Uterine hyperstimulation
•Cardiovascular effects (IV): hypo- or hypertension, Raynaud phenomenon,
palpitations, angina, arrhythmias
•Nausea, vomiting, abdominal pain, diarrhea
•Allergic reactions: skin rash or swelling of the face, lips, or tongue; or present with
headaches, dizziness, vertigo, and tinnitus
•Ergot toxicity: nausea, vomiting, dyspnea; vascular spasm, limb hypoperfusion,
seizures, hallucinations, coma
CONTRA
INDICATIONS
AND CAUTIONS
•Pregnancy
•Hypertension
•Cardiovascular disease
•Avoid in clients receiving alpha- or beta-agonists, triptans, azole antifungals, protease
inhibitors, and some macrolide antibiotics
•Use with caution in clients with hepatic or renal disease
15. ERGOT ALKALOIDS
PREFERRED ROUTE
OF ADMINISTRATION
•IM administration is preferred
•IV administration is used only in life-threatening situations
ASSESSMENTS
•Side effects: e.g., hypertension, headache, chest pain, uterine hyperstimulation
•Possible ergot toxicity: e.g., nausea, vomiting, tinnitus, dyspnea, numbness,
tingling and painful extremities
•Therapeutic response: control of hemorrhage, increased uterine tone
MONITORING
•Blood pressure, heart rate
•Uterine tone
•Vaginal bleeding
CLIENT EDUCATION
•It is safe to breastfeed after receiving this medication
•Report nausea, severe abdominal pain, numbness or tingling of extremities, or
increased bleeding
