In: Nursing
Dihydroergotamine
Dihydroergotamine is an ergot alkaloid, a derivative of ergotamine. Ergotamine is an alkaloid from ergot, that causes constriction of blood vessels and has been used to treat migrane.
(? Ergot: Any fungus in the genus Caviceps, which are parasitic on glasses)
Dihydroergotamine: Drug card
Generic name: Dihydroergotamine
Trade name: D.H.E , Migranal. DHE 45
Indications
* Severe Migraine
* Cluster headaches
* Status migrainosus
Dosage: 1mg IM, IV or S.C (Initial dose), can be repeated after 1 hr.
Maximum dose 2 mg / S.C or IM and 3mg IV.
Nasal spary: 1 spray in each nostril ( 0.5 mg / 1spray) , after 15 minutes, the next spray can administer .
Mechanism of Action
DHE act as an agonist to the receptors of Serotonin , thus causes vasoconstriction to in the cranial blood vessels. This inturn reduces headache.
Contraindications
* Peripheral vascular diseases. eg: Thrimboangitis obliterans, arteriosclerosis, thrombophlebitis
* Ischemic heart disease
* Pregnancy
* Hemiplegic migraine
* Diabetes and smoking
* Hepatic or renal impairment.
Side effects
* Dizziness, drowsiness
* GI disturbance like nausea, vomiting and diarrhoea.
* Flushing and increased sweating
Drug interactions:
* Avoid certain drugs , that will interact with Ergotamine, such as broncodialators, decongestants and other migraine medications
Eg: Epinephrine, pseudoephedrine, amphetamine , tryptan etc.
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