Methylergonovine, Ergonovine
Kelas obat: Agen Antineoplastik
Panganggone Methylergonovine, Ergonovine
Pendarahan Postpartum
Nyegah lan perawatan saka pendarahan postpartum ing ngarsane atonia uterine.
Administrasi alkaloid ergot parenteral ing tahap katelu saka persalinan nyuda rata-rata mundhut getih lan kedadeyan mundhut getih postpartum ≥500 mL.
Methylergonovine maleate: Agen lini pertama kanggo perawatan saka pendarahan postpartum; biasane diwenehi sawise oxytocin.
Ora bisa digunakake kanggo induksi utawa nambah tenaga kerja. Ora bisa digunakake ing kasus aborsi spontan sing kaancam.
Tes kanggo Varian Angina
Ergonovine maleate: Wis migunani kanggo diagnosa varian angina† [off-label]. Diwenehake IV kanggo nyebabake spasme arteri koroner ing pasien sing dicurigai angina varian.
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Carane nggunakake Methylergonovine, Ergonovine
Administrasi
Ergonovine maleate: Atur oral utawa injeksi IM. Nalika digunakake kanggo diagnosa varian angina† [off-label], wis diterbitake IV.
Methylergonovine maleate: Atur oral utawa injeksi IV utawa alon. Preparat parenteral uga wis disuntik langsung menyang corpus uterine† [off-label].
Aja injeksi intra-arterial utawa periarterial.
Injeksi IV
Methylergonovine maleate: Kanggo informasi kompatibilitas obat, deleng Kompatibilitas ing Stabilitas.
Methylergonovine maleate: Cadangan IV kanggo perdarahan uterus sing abot utawa kahanan darurat liyane sing ngancam nyawa. (Deleng Administrasi IV ing Caution.)
Yen diwenehi IV, monitor BP.
PengenceranMethylergonovine maleate: Bisa diencerake nganti volume 5 mL kanthi injeksi natrium klorida 0,9%.
Tingkat AdministrasiMethylergonovine maleate: Ngatur paling sethithik 1 menit.
Dosis
Kasedhiya minangka ergonovine maleate; dosis ditulis ing syarat-syarat ergonovine maleate.
Kasedhiya minangka methylergonovine maleate; dosis ditulis ing istilah methylergonovine maleate.
Dewasa
Postpartum Pendarahan Lisan utawa SublingualErgonovine maleate: Kanggo nyilikake pendarahan postpartum pungkasan, 0,2-0,4 mg saben 6-12 jam nganti atonia uterus wis liwati (biasane 48 jam). Dosis sing luwih murah bisa digunakake yen kram sing abot.
OralMethylergonovine maleate: Kanggo ngontrol perdarahan uterus sajrone nifas, 0,2 mg 3 utawa 4 kali dina nganti 1 minggu.
IMErgonovine maleate: 0,2 mg. Baleni yen perlu; pabrikan nyatakake yen dosis IM jarang dibutuhake luwih kerep tinimbang sapisan ing 2-4 jam.
IV utawa IMMethylergonovine maleate: 0,2 mg; baleni yen perlu saben 2-4 jam.
Tes Varian Angina† [off-label] IVErgonovine maleate: 0.1–0.4 mg wis digunakake.
Populasi Khusus
Gangguan Hepatik
Ora ana rekomendasi dosis khusus kanggo gangguan hepatik.
Gangguan Ginjal
Ora ana rekomendasi dosis khusus kanggo gagal ginjal.
Pasien Geriatrik
Methylergonovine maleate: Produsen nyaranake milih dosis kanthi ati-ati; diwiwiti ing mburi ngisor kisaran dosis amarga frekuensi sing luwih akeh nyuda fungsi ati, ginjel, lan/utawa jantung lan penyakit bebarengan lan terapi obat.
Pènget
Contraindications
Pènget / PancegahanPènget
IV Administrasi
Methylergonovine maleate: Aja rutin ngatur IV. Kemungkinan hipertensi dadakan lan kacilakan serebrovaskular nalika diwenehake IV.
Methylergonovine maleate: Yen administrasi IV dianggep nylametake nyawa, gunakake alon-alon; monitor BP. (Deleng Administrasi IV ing Dosis lan Administrasi.)
Pancegahan Umum
Singkirake panggunaan sing dawa; mandheg yen ergotism berkembang.
Penyakit sing bebarenganAti-ati ing pasien sing nandhang sepsis, penyakit jantung, shunt venoatrial, stenosis katup mitral, utawa penyakit pembuluh darah obliteratif.
Populasi Tertentu
KandhutanMethylergonovine maleate: Kategori C.
Methylergonovine lan Ergonovine: contraindicated nalika meteng amarga efek uterotonik obatan. (Deleng Contraindications.)
LaktasiMethylergonovine maleate: Disebarake menyang susu manungsa. Gunakake kanthi ati-ati ing wanita sing nyusoni.
Methylergonovine maleate: Bisa ditindakake kanthi lisan sajrone maksimal 1 minggu postpartum kanggo ngontrol pendarahan uterus. (Deleng Pendarahan Postpartum ing Dosis lan Administrasi.)
Panggunaan PediatrikKeamanan lan khasiat ora ditetepake ing bocah-bocah.
Panggunaan GeriatrikMethylergonovine maleate: Pengalaman ora cukup ing pasien ≥65 taun kanggo nemtokake apa pasien geriatrik nanggapi beda karo wong diwasa sing luwih enom.
Gangguan HepatikGunakake kanthi ati-ati.
Gagal GinjalGunakake kanthi ati-ati.
Efek Umum sing Sabar
Hipertensi, kejang, sirah, hipotensi, mual, muntah.
Apa obatan liyane bakal mengaruhi Methylergonovine, Ergonovine
Obat sing Ngaruhi Enzim Mikrosomal Hepatik
Methylergonovine maleate: Interaksi bisa karo obat-obatan sing inhibitor CYP3A4; potensial kanggo vasospasm, iskemia serebral, lan / utawa iskemia saka ekstremitas.
Panganggo bareng alkaloid ergot lan inhibitor protease HIV, delavirdine, utawa efavirenz dikontraindikasi. Amarga pendarahan postpartum amarga atonia uterine asring dikelola nganggo methylergonovine, Perinatal HIV Guidelines Working Group of Public Health Service Task Force wis ngetokake rekomendasi babagan panggunaan methylergonovine ing wanita sing nampa agen antiretroviral tartamtu. Kanggo rekomendasi babagan panggunaan methylergonovine ing pasien sing nampa inhibitor protease HIV, delavirdine, utawa efavirenz, deleng Obat Spesifik ing Interaksi.
Obat Spesifik
Obat
Interaksi
Komentar
Alkaloid Ergot
Efek farmakologis aditif
Ati-ati
Inhibitor protease HIV
Kemungkinan tambah konsentrasi alkaloid ergot lan potensial kanggo efek serius lan/utawa sing ngancam nyawa kayata keracunan ergot (vasospasm perifer lan iskemia saka ekstremitas lan jaringan liyane)
Kontraindikasi panggunaan bebarengan
Yen perawatan atonia uterus lan pendarahan postpartum sing berlebihan dituduhake ing wanita sing nampa inhibitor protease HIV, gunakake methylergonovine mung yen perawatan alternatif (misoprostol, Carboprost, oxytocin) ora bisa ditindakake. digunakake lan yen keuntungan potensial luwih gedhe tinimbang risiko; nggunakake methylergonovine ing dosis paling murah lan durasi paling cendhak bisa
Delavirdine
Mungkin konsentrasi alkaloid ergot sing tambah lan potensial kanggo efek serius lan/utawa sing ngancam nyawa kayata keracunan ergot (vasospasm perifer lan iskemia saka ekstremitas lan jaringan liyane)
Panganggone bebarengan contraindicated
Yen perawatan saka atonia uterine lan getihen postpartum gedhe banget dituduhake ing wong wadon nampa delavirdine, nggunakake methylergonovine mung yen perawatan alternatif (ie, misoprostol, carboprost, oxytocin) ora bisa digunakake lan yen keuntungan potensial luwih gedhe tinimbang risiko; nggunakake methylergonovine ing dosis paling murah lan durasi paling cendhak bisa
Efavirenz
Mungkin konsentrasi alkaloid ergot sing tambah lan potensial kanggo efek serius lan/utawa sing ngancam nyawa kayata keracunan ergot (vasospasm perifer lan iskemia saka ekstremitas lan jaringan liyane)
Kontraindikasi panggunaan bebarengan
Yen perawatan atonia uterus lan pendarahan postpartum sing berlebihan dituduhake ing wanita sing nampa efavirenz, gunakake methylergonovine mung yen perawatan alternatif (yaiku, misoprostol, carboprost, oxytocin) ora bisa digunakake lan yen keuntungan potensial luwih gedhe tinimbang risiko; nggunakake methylergonovine ing dosis paling murah lan durasi paling cendhak bisa
Vasokonstriktor
Efek farmakologi aditif
Ati-ati
Disclaimer
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