Ergot Alkaloids – Flashcards
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Current research indicates that ergotamine has antimigraine effects at which type of receptor site?
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Serotonin
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Which pharmacological actions of ergotamine are thought to abort migraine headaches?
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1. Depressing the vasomotor center 2. Promoting constriction of the cranial arteries 3. Blocking inflammation associated with the trigeminal vascular system
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To enhance bioavailability of ergotamine, which route will the nurse expect to use when administering this drug?
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Rectal
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A patient will begin taking an ergot alkaloid to treat migraine headaches. Which finding in the nursing assessment will the nurse report to the provider?
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History of coronary artery disease (CAD)
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Which pieces of information should the nurse include when teaching a female patient about taking ergotamine to treat migraine headaches?
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1. Do not take this drug while pregnant. 2. Seek immediate attention for cool or pale extremities. 3. Report rebound headaches that occur when the drug is withdrawn.
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Which additional assessment information will the nurse collect from Ms. Jacobs prior to the administration of ergotamine?
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Last menstrual period
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The health care provider discharges Ms. Jacobs with a prescription for ergotamine 2 mg sublingually as needed at the start of symptoms and q 30 minutes until migraine relief is achieved, not to exceed 6 mg in 24 hours. What will the nurse include in the teaching plan?
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1. Discuss relaxation techniques the patient may use before or during an attack. 2. Encourage the patient to take contraceptive measures while taking the medication. 3. Discuss possible triggers and strategies to avoid these triggers.
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Which health issue will the nurse include when teaching patients about signs of withdrawal that signify the development of ergotamine dependence?
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1. Nausea 2. Headache 3. Restlessness
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The nurse will include which measure when discussing ways to prevent migraine headaches for a patient who receives a new prescription for ergotamine?
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Biofeedback
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A patient who has chronic migraine headaches and who has not responded to triptan therapy will begin taking ergotamine. How should this be administered?
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Orally; immediately after the onset of aura or headache
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A female patient asks why her provider has suggested avoiding red wine, cheese, and chocolate as part of her antimigraine therapy. How should the nurse respond?
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"These foods contain tyramine, which can trigger a migraine attack."
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A patient who has frequent migraine headaches tells the nurse she will take ergotamine daily to see if this will prevent her migraines. What should the nurse tell this patient?
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"Daily use will result in migraine-like withdrawal symptoms when the drug is discontinued."
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A patient who has frequent mild-to-moderate migraine headaches does not want to take ergotamine regularly. What should the nurse recommend to this patient?
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Using non-steroidal anti-inflammatory medications for milder symptoms
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A patient who has been taking sumatriptan to treat migraine headaches receives a prescription for sublingual ergotamine. What should the nurse include when teaching the patient about using these medications?
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"Do not take sumatriptan and ergotamine within 24 hours of each other to avoid serious adverse effects."
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A female patient who uses sublingual ergotamine will begin taking fluconazole to treat a vaginal yeast infection. What should the nurse caution this patient about using both medications?
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"Use ergotamine sparingly and report pain or pallor of the extremities or changes in cognition immediately."
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A patient who uses sublingual ergotamine calls the clinic to report no headache relief after administering a second dose one hour after the initial dose. Which action should the nurse recommend?
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"Administer another dose 30 minutes after the last dose and call the clinic if this is not effective."
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A patient begins using ergotamine to treat migraine headaches and reports having increased nausea and vomiting. What should the nurse tell this patient?
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"This side effect of ergotamine can be treated with an antiemetic medication."
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A hospitalized patient has received 2 doses of sublingual ergotamine to treat a migraine, and reports calf muscle pain and numbness in the toes in both extremities. The nurse notes that the patient's feet are cool and pale. What should the nurse do?
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Notify the health care provider immediately
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A patient reports a recent increase in frequency of migraines several months after beginning therapy with sublingual ergotamine. Before advising this patient, what should the nurse assess?
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1. Changes in diet or alcohol intake 2. Frequency of ergotamine dosing
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A patient who uses sublingual ergotamine reports that migraines often begin during staff meetings at work. What should the nurse recommend for this patient?
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Have tablets available during meetings to take upon onset of symptoms.
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A patient with migraines reports getting repeated headaches often after taking ergotamine to resolve headaches in the past few weeks. Which questions should the nurse ask to help determine the cause of this change?
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"Is there a recent increase in frequency of ergotamine use?"
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A patient asks what do to in order to minimize the need for repeated doses of ergotamine once a migraine starts. How should the nurse respond?
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"Try to rest in a dark room for several hours after the first dose."
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A patient who has begun using biofeedback and yoga to prevent migraines reports no change in frequency of headaches. What should the nurse include as part of ongoing teaching for this patient?
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A discussion of potential dietary causes of migraine headaches
