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ERGOT ALKALOIDS: The amine alkaloid ergometrine and its semi synthetic analogue methylergometrine have prominet uterine action and are used in obstetrics. They increase force, frequency and duration of contraction. Gravid uterus is more sensitive, specially at term and in early puerparium. The vasoconstrictor and uterotonic actionof ergot alkaloids is velieved to result form partial agonistic action and adernergic and 5 HT receptors.

Indications: Active management of 3rd stage of labour. Uterine atony/heamorrhage during and after third stage of labour, in association with ceasarean section following abortion, aubinolution of the uterus, lochiometra, puerperal bleeding.

Dosage: Active management of 3rd stage of labour : 0.1 to 0.2 mg slowly i. v. uterine atony/heamorrhage: 0.2mg i.m. or 0.1 to 0.2 mg i.v. may e related at intervals of not less than 2 hrs. Subinolution, lochiometra, puerperal bleeding: 0.125 to 0.25 mg orally or 0.1- 0.2 mg s.c. or i.m., up to 3 times daily in lactating women preferable not longer then 3 days.

Contra- indications: severe hypertention,pregnancy,first stage of labour, second stage of labour before crwning of head; hypertensive toxaemia occlusive vascular disease, sepsis. Hypersensitvity.

Special Precautions: Don’t give drug before delivery of child (last child in multiple pregnancies). Breach persentation. Hepatic or renal impairment, toxeamia of pregnancy, pelvic sepiss, obliterative vascular diseases.

Pregnancy: Treatment only during third stage of labour.
Lactation: Should not be used.

Side effects : Nausea, vomiting,rise in BP, decreased milk secretion, gangerne

Drug Interaction: Smoking beta blockers, and methylsergide increase risk of vascular occulsion simultaneous use of Oral contraceptives increase risk of thrombosis. Erthromycin increases plasm concentration of Ergotamine.