ERGOT.
Martindale�s 24th
Compiled and edited by Ivor Hughes
ERGOT
and ERGOT ALKALOIDS.
Ergot
(B.P.C., I.P.). Secale Cornutum (I.P.);
Rye
Ergot; Ergot de Seigle; Mutterkorn; Cornezuelo de centeno.
The
sclerotium of the fungus Claviceps purpurea (Hypocreaceae) developed in
the ovary of the rye, Secale cereale
(Gramineae), containing not less than 0-2% of total alkaloids of which not
less than 15% consists of water-soluble alkaloids. I.P. specifies not less
than 0-15% of total alkaloids and not less than 0'023% of water-soluble
alkaloids.
Foreign Pharmacopoeias: In all pharmacopoeias examined except Mex. and
U.S.
but in U.S.N.F.
The
specified content of alkaloids varies but is usually lower than the B.P.C.
minima. U.S.N.F. has not less than 0-15% of total alkaloids and not less
than 0-01% of water-soluble alkaloids.
Ergot
should be thoroughly dried, kept entire, and stored in a cool place. If
powdered and stored without the immediate removal of the fat the
alkaloidal content decreases.
Note.
When Ergot or Powdered Ergot is prescribed, Prepared Ergot is dispensed.
Toxic
Effects.
Acute poisoning is rare and usually results from the use of large
quantities as an abortifacient. Symptoms are nausea, vomiting, diarrhoea,
thirst, coldness of the skin, rapid and weak pulse, numbness and tingling
of the extremities, confusion and unconsciousness. Chronic ergotism may
result from therapeutic overdosage, especially following administration to
patients with severe infection (such as puerperal fever), liver disease,
or hyperthyroidism. Circulatory disturbances are usually the first
symptoms to appear, including coldness of the skin, severe muscle pains,
and vascular stasis resulting in dry peripheral gangrene. Other symptoms
are headache, nausea, vomiting, diarrhoea, dizziness and weakness of the
legs. Nervous symptoms are confusion, depression, drowsiness, hemiplegia
and convulsions. Epidemic ergot poisoning, arising from the ingestion of
ergotised rye bread, is now seldom seen. Two
forms of epidemic toxicity have been described, a gangrenous form
characterised by agonising pain of the extremities of the body followed by
dry gangrene of the peripheral parts and a rarer nervous type giving rise
to paroxysmal, epileptiform convulsions. These two types of ergotism
rarely, if ever, occur together.
Antidotes.
Treatment of acute poisoning is symptomatic. In cases of chronic poisoning
treatment consists in complete withdrawal of the drug and attempts to
prevent gangrene by maintaining an adequate circulation in the affected
parts. Vasodilators such as the Choline esters, nitrites or papaverine may
be tried, together with mechanical procedures to restore the circulation.
In more severe cases, impending gangrene may be averted by the use of
paravertebral block or ganglionic blocking agents. Nausea and vomiting may
be relieved by atropine. Muscle pains which do not respond to massage or
exercise may be relieved by the intravenous injection of 10 ml. of
Injection of Calcium Gluconate
Uses.
Ergot stimulates the smooth muscle of the body, especially of the blood
vessels and uterus, and its use is almost entirely confined to obstetrics.
Because it produces prolonged uterine contraction it is especially
employed to check post-partum haemorrhage; it is dangerous if administered
in the early stages of labour. The action of ergot depends on its
alkaloidal content, especially of ergotamine, ergotoxine and ergometrine.
Of these, ergometrine is the only one which produces a rapid oxytocic
effect by mouth and the use of this alkaloid is often preferred to
preparations of the whole drug because of the more exact dosage which can
be given, the specific action on the uterine muscle, and the fact that it
has much less tendency to give rise to gangrene. Ergot is usually given as
capsules or tablets of prepared ergot, or as extract or liquid extract of
ergot. The liquid extract loses its activity very rapidly, especially when
diluted in mixtures.
Prepared
Ergot (B.P.C.,
Ind.
P.).
Pulvis Secalis Cornuti Standardisatus (I.P., Egyp. P.). Powdered and defatted ergot
adjusted to contain 0'2% of alkaloids, of which not less than 15% consists
of water-soluble alkaloids. Protect from light and moisture in a cool
place.
Dose:
150 to 500 mg. (2� to 8 grains).
Caps. Ergot. (B.N.F.).
Ergot Capsules; Capsules of Prepared Ergot. Unless otherwise specified,
capsules each containing 2� grains of
prepared ergot are supplied.
Ext.
Ergot. (B.P.C. 1949). Extract of Ergot.
A soft extract prepared by macerating and percolating defatted ergot with
alcohol (50%) acidified with sulphuric acid. It contains, when fresh, 0-5%
w/w of alkaloids, and after storage, not less than 0-35%. Protect from
moisture in a cool place.
Dose:
60 to 200 mg. (1 to 3 grains).
Ext.
Ergot. Liq. (B.P. 1914). Prepared by macerating ergot 100 g.
with 500 ml. of water for 12 hours, straining, repeating the maceration
with 250ml. of water, straining, evaporating the mixed liquids to 70 ml.,
adding 37-5 ml. of alcohol (90%), setting aside for an hour and then
filtering. The product measures about 100 ml.
Dose:
0-6 to 2 ml. (10 to 30 minims).
Liquid
Extract of Ergot (B.P.C.).
Ext. Ergot. Liq.; Ergot Fluidextract; Extractum
Secalis Cornuti Fluidum.
Prepared by macerating and percolating defatted ergot with alcohol (50%)
acidified with tartaric acid. It contains, when fresh, 0'06% w/v of
alkaloids, and after storage not less than 0-04%. It loses activity on
keeping, the rate being rapid at ordinary temperatures but slow at 0�.
Store in completely filled containers in as cool a place as possible.
Dose:
0-6 to 1.2 ml. (10 to 20 minims). A similar liquid extract is included in
many foreign pharmacopoeias. U.S.N.F, has a 1
in 1 extract.
STABILITY.
Liquid extract of ergot deteriorates rapidly and even when stored in a
refrigerator in completely filled bottles of blue or amber glass it should
not be kept for more than 9 months. (B. K. Ghosh et
al., Indian Pharm., 1948, 3, 81.)
Mist. Ergot. (N.F.
1939). Liquid extract of ergot (B.P. 1914)
15 m., chloroform water
to � fluid oz.
Dose:
15 ml. (� fl. oz.).
Note.
Ergot is best administered as capsules or tablets of prepared ergot.
Nicholson's
Pill. Extract of ergot (B.P.
1914)
1� gr., quinine sulphate 1� gr., dry extract of nux vomica � gr.,
digitalis � gr.; potato starch and lactose to 5 gr. Usually prepared in
tablet form.�Retail Chem., 1953, 24, 96.
Tablets
of Ergot (B.P.C.). Tab. Ergot. (B.N.F.);
Tablets of Prepared Ergot.
Unless otherwise specified, tablets each containing 2� grains of prepared
ergot are supplied. Store in air-tight containers in a
cool place. The B.N.F. directs that the tablets be crushed before
being swallowed.
Tinct.
Ergot. Ammon. (B.P.C.
1934). Ammoniated Tincture of Ergot.
Prepared by percolating ergot 25 g. with dilute
solution of ammonia 10 ml. and alcohol (60%) to 100 ml.
Dose:
2
to 4
ml. (30 to 60 minims).
See also; Oxytocics
Martindale's 24th
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