Ergotamine is contraindicated in all of the following EXCEPT(LQ)
|C||Ischemic heart disease|
a. It acts as a partial agonist and antagonist at a adrenergic and all subtypes of 5 HT1 and 5HT2 receptors, but does not interact with 5-Ht3 or dopamine receptors
b. Produces sustained vasoconstriction, visceral smooth muscle contraction, vasomotor centre depression and antagonizes the action of NA and 5-HT on smooth muscles.
c. The compound also has the properties of serotonin antagonism.
• Indicated as therapy to abort or prevent vascular headache, e.g., migraine, migraine variants or so-called “histaminic cephalalgia”.
a. Nausea, vomiting, abdominal pain, muscle cramps, weakness, paresthesias, coronary and other vascular spasm, chest pain are the frequent side effects.
b. These drugs are contraindicated in presence of sepsis, ischemic heart disease, peripheral vascular disease, hypertension, pregnancy, liver and kidney disease.
a. Co-administration of ergotamine with potent CYP 3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin) has been associated with acute ergot toxicity (ergotism) characterized by vasospasm and ischemia of the extremities with some cases resulting in amputation.
b. There have been rare reports of cerebral ischemia in patients on protease inhibitor therapy