Ergometrine 500micrograms/1ml solution for injection ampoules

Background: Blood loss of 500 milliliters or more from the vaginal tract following delivery is referred to as postpartum hemorrhage. Even within the usual range, a parturient with severe anaemia may die from hemorrhage. Aim: For the purpose of contrasting the safety and effectiveness of intravenous methyl ergometrine with oral misoprostol in preventing postpartum hemorrhage in women having a normal vaginal birth.Subjects and methods: Over the course of a year, 140 patients from the Obstetrics and Gynecology Department at Al-Azhar University Hospitals in Cairo, Egypt, participated in this prospective randomized controlled trial.Results: The misoprostol group had a significantly higher proportion of primigravid patients (54.3% vs 35.7%, p=0.021), which is clinically relevant as primigravidity is associated with increased risk of PHH and different uterine contractility patterns. The incidence of blood loss>500mL was similar between groups (17.1% vs 21.4%, p=0.33), as was severe hemorrhage>1000mL (1.4% vs 1.4%, p=0.75).Conclusion: The 400μg sublingual misoprostol is as effective as 200μg intravenous methylergonovine for preventing PHH, with comparable safety profiles. The equivalent efficacy, combined with misoprostol's practical advantages in terms of stability, route of administration, and cost, supports its use as a viable alternative to methylergonovine for PHH prevention.

Abstract licence: CC BY-SA

Food contamination has been a major health issue since the beginning of human existence. Some food contaminants trigger important psychological manifestations, such as delirium, hallucinations, and psychosis, which may cause distress, aggravate pre-existing conditions, and dangerously interact with certain medications. Exposure to psychoactive food contaminants can ultimately lead to severe health problems or even death. As such, it is important to further study these substances to prevent contamination and identify and treat intoxications. Among these substances, three classes of food contaminants are addressed herein due to their toxicological relevance: (i) ergot alkaloids (ergotamine and ergometrine), (ii) tropane alkaloids (atropine, hyoscyamine, and scopolamine), and (iii) opium alkaloids (codeine and morphine). An historical perspective relative to each contaminant is briefly described in this review, as well as the dietary sources and key chemical properties. Guidance values and analytical methods that allow the detection and quantification of these toxic agents are also provided. In addition, relevant toxicokinetic and toxicodynamic aspects are summarized. Finally, for each xenobiotic, registered intoxication cases, from epidemics and outbreaks to case reports, are described, as well as the detection of contaminants in screening procedures. Overall, this review reinforces that dietary exposure to psychoactive contaminants constitutes a toxicological issue that should be duly considered.

Abstract licence: CC BY

: Drug induced vasculitis is an inflammation of blood vessels caused by use of various drugs like ergometrine, inotropes. The purpose of this review is to highlight the importance of ergotism as a cause of peripheral vascular ischemia and analyze the changes associated with this condition. Mrs. XX, 21 year old, P2L1 presented with history of normal delivery in PHC eight days back with complaints of breathlessness, fever and bluish grey discoloration of both lower extremities since her delivery. There was history of severe postpartum hemorrhage post delivery in the PHC and was medically managed with ergometrine and other oxytocics. On examination, patient had pallor, temperature and tachycardia. Dorsalis pedis pulsation was palpable in both lower limbs. Thorough workup was done which revealed hemoglobin 6.9 gm% and high total count. Doppler study of both lower limbs and ECHO were normal. Patient was managed conservatively after which she improved symptomatically but there was no improvement in the line of demarcation in both lower limbs. Due to financial constraints, patient decided to shift to government setup for further management. Ergometrine is recommended by ACOG and RCOG for use in the medical management of atonic postpartum hemorrhage after oxytocics. Ergometrine has a vasoconstrictive effect which causes progressive vasospasm leading to peripheral ischemia and gangrene which may lead to amputation of the limbs. Hence, management of postpartum hemorrhage with minimum effective dose of ergometrine should be emphasized and use of other oxytocics should be encouraged to prevent such major complications.

Abstract licence: CC BY-NC-SA

A certain group of mycotoxins, the ergot alkaloids, has caused countless deaths throughout human history. They are found in rye and other cereals and ingesting contaminated foods can cause serious health problems. To identify contaminated food exceeding the legal limits for ergot alkaloids, a portable and cost-effective test system is of great interest to the food industry. Rapid analysis can be achieved by screening for a marker compound, for which we chose ergometrine. We developed a magnetic bead-based immunoassay for ergometrine with amperometric detection in a flow injection system using a handheld potentiostat and a smartphone. With this assay a limit of detection of 3 nM (1 μg L−1) was achieved. In spiked rye flour, ergometrine levels from 25 to 250 μg kg−1 could be quantified. All results could be verified by optical detection. The developed assay offers great promise to meet the demand for on-site ergometrine detection in the food industry.

Abstract licence: CC BY-NC-ND

Hallucinogenic drugs are used because they have effects on the central nervous system. Their hallucinogenic effects probably occur via stimulation of serotonin receptors, namely, 5-HT 2A -serotonin receptors in the brain. However, a close study reveals that they also act on the heart, possibly increasing the force of contraction and beating rate and may lead to arrhythmias. Here, we will review the inotropic and chronotropic actions of bufotenin, psilocin, psilocybin, lysergic acid diethylamide (LSD), ergotamine, ergometrine, N,N-dimethyltryptamine, and 5-methoxy-N,N-dimethyltryptamine in the human heart.

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Abstract Ergometrine (6a R ,9 R )- N -(( S )-1-hydroxypropan-2-yl)-7-methyl-4,6,6a,7,8,9-hexa-hydro-indolo-[4,3- fg ]chinolin-9-carboxamide or lysergide acid β-ethanolamide or ergonovine) activates several types of serotonin and histamine receptors in the animal heart. We thus examined whether ergometrine can activate human serotonin 5-HT 4 receptors (h5-HT 4 R) and/or human histamine H 2 receptors (hH 2 R) in the heart of transgenic mice and/or in the human isolated atrium. Force of contraction or beating rates were studied in electrically stimulated left atrial or spontaneously beating right atrial preparations or spontaneously beating isolated retrogradely perfused hearts (Langendorff setup) of mice with cardiac specific overexpression of the h5-HT 4 R (5-HT 4 -TG) or of mice with cardiac specific overexpression of the hH 2 R (H 2 -TG) or in electrically stimulated human right atrial preparations obtained during cardiac surgery. Western blots to assess phospholamban (PLB) phosphorylation on serine 16 were performed. Ergometrine exerted concentration- and time-dependent positive inotropic effects and positive chronotropic effects in atrial preparations starting at 0.3 µM and reaching a plateau at 10 µM in H 2 -TGs ( n = 7). This was accompanied by an increase in PLB phosphorylation at serine 16. Ergometrine up 10 µM failed to increase force of contraction in left atrial preparations from 5-HT 4 -TGs ( n = 5). Ten micrometer ergometrine increased the force of contraction in isolated retrogradely perfused spontaneously beating heart preparations (Langendorff setup) from H 2 -TG but not 5-HT 4 -TG. In the presence of the phosphodiesterase inhibitor cilostamide (1 µM), ergometrine at 10 µM exerted positive inotropic effects in isolated electrically stimulated human right atrial preparations, obtained during cardiac surgery, and these effects were eliminated by 10 µM of the H 2 R antagonist cimetidine but not by 10 µM of the 5-HT 4 R antagonist tropisetron. Furthermore, ergometrine showed binding to human histamine H 2 receptors (at 100 µM and 1 mM) using HEK cells in a recombinant expression system (p K i < 4.5, n = 3). In conclusion, we suggest that ergometrine is an agonist at cardiac human H 2 Rs.

Abstract licence: CC BY

Background: There is a need for signs that will help the midwives or the health care providers attending deliveries to prevent the patient from going into hypovolemic shock, especially when immediate testing is not possible. The study aims to find the correlation between the clinical symptoms and blood loss in women with postpartum hemorrhage. Methods: It is a descriptive observational study conducted at the Department of Obstetrics and Gynecology, Maternity Hospitals. Women treated with either Misoprostol or Ergometrine during delivery were included in the study. Data were collected for Packed Cell Volume (PCV), Hemoglobin (Hb%), etc. ; other investigations include general clinical condition, presence or absence of PPH, and amount of blood loss using laboratory reports. Results: The study has reported clinical findings and blood loss to identify the correlation between them. Only 4% of women suffered blood loss of more than 500 mL, i.e., postpartum hemorrhage (PPH) occurred among them. The change in Hb% among the majority of the women was ranging between 0–0.5 gm% (71.5%). Most cases (72.72%) had tachycardia followed by palpitation (10.90%). Blood loss exceeding 1500 mL was correlated with hypotension, restlessness, and oliguria. Conclusions: Extra vigilance is needed to identify women at risk and facilitate early intervention and treatment of PPH.

Abstract licence: CC BY

Background: Ergometrine is part of the current guideline-directed management of post-partum haemorrhage (PPH). However, it is also a potent vasoconstrictor capable of causing significant coronary artery vasospasm in susceptible individuals. Case summary: A 31-year-old primigravida suffered from post-partum haemorrhagic shock and disseminated intravascular coagulation following vaginal delivery. She was urgently resuscitated with intravenous fluids and blood products. Intramuscular ergometrine was administered, and surgery was required due to retained placenta. Two days later upon extubation, she demonstrated symptoms of speech apraxia. Brain magnetic resonance imaging (MRI) revealed extensive cerebral and cerebellar infarction with subcortical sparring. Her electrocardiogram showed diffuse T-wave inversions, and a high-sensitivity troponin-I peaked at 37 000 ng/L. Echocardiography showed severe left ventricular (LV) failure, apical akinesia, and thrombi formation. One week later, she suffered a middle cerebral artery stroke causing aphasia and right-sided hemiparesis, necessitating emergency thrombectomy. Cardiovascular MRI showed moderate LV systolic impairment and focal apical infarction. Coronary angiography was unremarkable. The most likely unifying diagnosis was severe ergotamine-induced coronary vasospasm causing acute myocardial infarction in the setting of life-threatening PPH. Following three weeks of multi-disciplinary care, her speech and motor abilities improved. She was discharged on long-acting nitrates, oral anticoagulation, and heart failure therapy with close outpatient monitoring. Subsequent echocardiograms showed marked improvement in LV ejection fraction (45%-50%). Discussion: This case highlights the potential life-threatening complications of ergometrine and the importance of recognizing pregnancy-associated myocardial infarction as a significant cause of maternal morbidity and mortality. The cardio-obstetrics team plays a pivotal role in improving patient outcomes.

Abstract licence: CC BY