DRUG STUDY

MEDICATION DRUG CLASSIFICATION INDICATION MECHANISM OF ACTION SIDE EFFECTS/ ADVERSE REACTIONS CONTRAINDICATIONS AND CAUTIONS NURSING RESPONSIBILITIES

Methylergonovine Pronunciation (meth il er goe NOE veen) Index Terms Methylergometrine Maleate Methylergonovine Maleate

Ergot alkaloids and derivatives, OxytocicsStimulants, uterine

Prevention and treatment of postpartum and postabortion hemorrhage caused by uterine atony or subinvolution

Similar smooth muscle actions as seen with ergotamine; however, it affects primarily uterine smooth muscles producing sustained contractions and thereby shortens the third stage of labor and reduces blood loss.

Frequency not defined. Cardiovascular: Acute MI, arterial spasm, bradycardia, hyper-/hypotension, palpitation, tachycardia, temporary chest pain Central nervous system: Dizziness, hallucinations, headache, seizure Dermatologic: Rash Endocrine & metabolic: Water intoxication Gastrointestinal: Diarrhea, foul taste, nausea, vomiting Local: Thrombophlebitis

Hypersensitivity to methylergonovine or any component of the formulation; ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy Precautions:

Determine patients with history of high blood pressure or blood vessel, heart, kidney or liver diseases. Inspect IM and IV injection sites frequently for signs of phlebitis

Report onset of increased blood pressure (severeheadache, blurred vision); seizure (convulsions) ; feeling lightheaded, fainting; pounding heartbeat; chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; or hallucinations.

U.S. Brand Names Methergine

Canadian Brand Names Methergine

Cardiac valvular fibrosis: Ergot alkaloids have been associated with fibrotic valve thickening (eg, aortic, mitral, tricuspid); usually associated with long-term, chronic use. Ergotism: Ergot alkaloid use may result in ergotism (intense vasoconstriction)

Continuously monitor V/S Ask patient to report side

Neuromuscular & skeletal: Leg cramps Otic: Tinnitus Renal: Hematuria Respiratory: Dyspnea, nasal congestion Miscellaneous: Anaphylaxis, diaphoresis

resulting in peripheral vascular ischemia and possible gangrene. Ergotism is usually associated with overdosage or prolonged chronic use; do not exceed dosing guidelines and avoid prolonged administration. Pleural/retroperitoneal fibrosis: Rare cases of pleural and/or retroperitoneal fibrosis have been reported with prolonged daily use of other ergot alkaloids.

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