Ergonovine

INTRODUCTION

Indications

Prevention and treatment of postpartum or postabortion hemorrhage caused by uterine atony or involution. Unlabeled Use: As a diagnostic agent to provoke coronary artery spasm.

Action

Directly stimulates uterine and vascular smooth muscle. Therapeutic Effects: Uterine contraction.

Adverse Reactions/Side Effects

CNS: dizziness, headache. EENT: tinnitus. Resp: dyspnea. CV: arrhythmias, chest pain, hypertension, palpitations. GI: nausea, vomiting. Derm: sweating. Misc: allergic reactions.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report any rhythm disturbances or symptoms of increased arrhythmias, including palpitations, chest pain, shortness of breath, dyspnea, fainting, and fatigue/weakness.

• Assess blood pressure (BP) and compare to normal values (See Appendix F). Report a sustained increase in BP (hypertension).

• Monitor signs of allergic reactions, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

• Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician and nursing staff, and caution the patient and family/caregivers to guard against falls and trauma.

Interventions

• Because of the risk of arrhythmias and abnormal BP responses, use caution during aerobic exercise and other forms of therapeutic exercise. Assess exercise tolerance frequently (BP, heart rate, fatigue levels), and terminate exercise immediately if any untoward responses occur (See Appendix L).

Patient/Client-Related Instruction

• Instruct patient or family/caregivers to report other troublesome side effects such as severe or prolonged headache, ringing/buzzing in the ears (tinnitus), increased sweating, or GI problems (nausea, vomiting).

Pharmacokinetics

Absorption: Well absorbed after oral or IM administration.

Distribution: Unknown.

Metabolism and Excretion: Unknown. Probably metabolized by the liver.

Half-life: Unknown.

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Avoid chronic use; Should not be used to induce labor.

Use Cautiously in: Hypertensive or eclamptic patients (increased susceptibility to hypertensive and arrhythmogenic side effects); Severe hepatic or renal disease; Sepsis; Third stage of labor.

Interactions

Drug-Drug: Excessive vasoconstriction may result when used with other vasopressors, such as dopamine or nicotine. May ↑ the ...