FRCA Notes


Ergometrine


  • An ergot alkaloid derivative with a chemical structure similar to LSD
  • 500μg/ml colourless solution
  • 500μg tablets
  • In combination with oxytocin as syntometrine

  • To cause uterine contraction and reduce bleeding following delivery and in the management of PPH
  • Given via:
    • 500mcg IM bolus
    • 250 - 500mcg slow IV bolus

  • The mechanism of action isn't fully elucidated, although:
    • Stimulates uterine and vascular smooth muscle contraction, possibly through binding of 5HT3, dopamine or ɑ-adrenergic receptors
    • Stimulates D2 dopamine receptors at the CTZ to cause emesis

  • Increased SVR, PVR and consequent hypertension - is contraindicated in pre-eclampsia, hypertension, cardiac disease and in porphyria
  • Headache, dizziness, tinnitus
  • Severe nausea and vomiting - especially if given IV

  • Effects onset within 1 minute (IV) or 5 minutes (IM)
  • Effects last up to 6hrs
  • Metabolised in the liver
  • Excreted in bile