II. Indications
-
Postpartum Hemorrhage
- After delivery of the anterior Shoulder and placenta
- Uterine Hemorrhage
- Dilation and Curettage associated Hemorrhage
- Early Pregnancy Loss associated Hemorrhage
- Uterine Inversion associated Hemorrhage (following Uterus replacement)
III. Contraindications
IV. Mechanism
- Ergonovine is used worldwide as a uterotonic agent in Postpartum Hemorrhage
- Methylergonovine (Methergine) is an Ergonovine homolog, with an added methyl group
- Methylergonovine is used in the U.S. instead of Ergonovine
- Ergonovine has a long history of use and was originally extracted from rye ergot fungus
- It can also be synthesized from Lysergic Acid
- Ergonovine can be used to synthesize Lysergic Acid Diethylamide (LSD)
- Ergonovine is an ergot alkaloid
- Increases uterine tone and contraction
- Increases vascular smooth Muscle Contraction (Vasoconstriction)
- Ergonovine has complex interactions at multiple receptors
- Adrenergic Receptors
- Dopamine receptors
- Tryptamine receptors
- Serotonin receptors
- Ergonovine also decreases Prolactin levels
- May decrease Lactation
V. Dosing
- See other references
VI. Adverse Effects
- Similar to Methylergonovine
- Cardiovascular
- Cardiac Arrhythmia
- Hypertension
- Paradoxical Hypotension has also been reported
- Neurologic
- Gynecologic
- Abdominal Pain or cramping
- Nausea or Vomiting
VII. Safety
- Avoid in Lactation
- Contraindicated in pregnancy (except postpartum or after pregnancy loss)
VIII. Resources
- Olson (2020) Clinical Pharmacology, Medmaster, Miami, Fl, p. 154
- Ergometrine (Wikipedia)