Ergotism: Difference between revisions
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*Miosis | *Miosis | ||
*Burning sensation in extremities | *Burning sensation in extremities | ||
*Cerebrovascular ischemia | *[[CVA|Cerebrovascular ischemia]] | ||
*Seizures | *[[Seizures]] | ||
*Cardiac ischemia | *[[Myocardial ischemia|Cardiac ischemia]] | ||
*GI disturbances | *GI disturbances | ||
*Peripheral ischemia | *Peripheral ischemia | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Atypical migraine | *Atypical [[migraine]] | ||
*CVA | *[[CVA]] | ||
==Workup== | ==Workup== | ||
| Line 24: | Line 24: | ||
==Management== | ==Management== | ||
*Intake within 2 hours | *Intake within 2 hours | ||
**Considered activated charcoal | **Considered [[activated charcoal]] | ||
**Consider definitive airway | **Consider definitive airway | ||
*Mild ergotism | *Mild ergotism | ||
**IVF | **[[IVF]] | ||
** | **[[Antiemetics]] | ||
**Analgesia | **[[Analgesia]] | ||
*Severe Peripheral Vasoconstriction or Ischemia | *Severe Peripheral Vasoconstriction or Ischemia | ||
**Vasodilators - nitroprusside, nitroglycerine | **Vasodilators - [[nitroprusside]], [[nitroglycerine]] | ||
**Consider corticosteroids | **Consider [[corticosteroids]] | ||
**Consider | **Consider [[heparin]]ization | ||
==Disposition== | ==Disposition== | ||
*Consider | *Consider observation for mild ergotism | ||
*Admission for severe ergotism | *Admission for severe ergotism | ||
Latest revision as of 17:29, 24 September 2019
Background
- Long term effects of ergotamine usage or ergot poisoning
- Coadministration of ergotamine medication with triptan or certain antibiotics
- Increase in serotonin activity
- α-adrenergic agonist activity peripherally
Clinical Features
- Usage of ergotamines such as dihydroergotamine (DHE) and methylergometrine (Methergine)
- Miosis
- Burning sensation in extremities
- Cerebrovascular ischemia
- Seizures
- Cardiac ischemia
- GI disturbances
- Peripheral ischemia
Differential Diagnosis
Workup
Management
- Intake within 2 hours
- Considered activated charcoal
- Consider definitive airway
- Mild ergotism
- Severe Peripheral Vasoconstriction or Ischemia
- Vasodilators - nitroprusside, nitroglycerine
- Consider corticosteroids
- Consider heparinization
Disposition
- Consider observation for mild ergotism
- Admission for severe ergotism
See Also
External Links
References
Goldfrank"s Toxicologic Emergencies, 9th Ed. Pgs 705-706, 763-769, and 1060-1064.