Mindanao State University – Iligan Institute of Technology Student: Ancog, Justin Lowel A.

Block: 263
COLLEGE OF NURSING

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: Methergine Generic Name: Methylergonovine Drug Classification: Ergot Alkaloid-Uterotropic

Dosage, Route & Frequency Drug-Drug & Drug-Food Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Interactions (By System) (By System)
(Adults) Methergine Drug-drug. Ergot alkaloids, Following delivery of Contraindicated in GI: nausea, CNS: dizziness,
Postpartum 1amp (methylergonovine sympathomimetic the placenta, for vaginal delivery, vomiting, stomach headache,
Hemorrhage (0.2mg/mL) IVTT maleate) acts directly amines:  Enhances routine management proven cephalopelvic pain, diarrhea, hallucination,
0.2 mg IM/IV q2-4hr (one dose only) vasoconstrictor seizures, CVA (with
on the smooth of uterine atony disproportion, fetal GU: leg cramps,
PRN; not to exceed potential. Use together I.V. use)
5 doses, THEN 0.2- muscle of the uterus cautiously. hemorrhage, and intolerance of labor, CV: hypertension,
0.4 mg PO q6-8hr and increases the Local anesthetics with subinvolution of the hypersensitivity, Integumentary hypotension,
PRN for 2-7 days tone, rate, and vasoconstrictors (lidocaine uterus. For control anticipated System: skin rash transient
Administer IV only in amplitude of rhythmic with epinephrine):  Enhances of uterine nonvaginal delivery, chest pain,
emergency because vasoconstriction. Use CNS: headache, palpitations,
contractions. Thus, it hemorrhage in the pregnancy (intranasal dizziness,
of potential for induces a rapid and together cautiously. second stage of spray thrombophlebitis
Hypertension & CVA nefazodone; EENT: tinnitus, nasal
sustained titanic labor following EENT: ringing in
Administer over >1 antifungal medicines: congestion
minute and monitor uterotonic effect fluconazole, itraconazole, delivery of the your ears, stuffy GI: nausea, vomiting,
BP which shortens the ketoconazole, anterior shoulder. nose, or unpleasant diarrhea
third stage of labor posaconazole, voriconazole; taste in your mouth. GU: hematuria
and reduces blood hepatitis C medicines: Musculoskeletal:
loss. The onset of boceprevir, telaprevir; or leg cramps
action after I.V. HIV or AIDS medicines: Respiratory:
atazanavir, cobicistat dyspnea
administration is
(Stribild, Tybost), darunavir, Skin: diaphoresis,
immediate; after I.M. delavirdine, fosamprenavir, rash, allergic
administration, 2-5 indinavir, nelfinavir, ritonavir, reactions
minutes, and after saquinavir. Other: foul taste
oral administration, Drug-lifestyle. Smoking
5-10 minutes. (nicotine):  Enhances
vasoconstriction. Discourag
e smoking.
Drug-food. Grapefruit juice
may increase the effects of
the drug in narrowing blood
vessels and decreasing
 blood flow.

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment
■ Assess lochia and uterine tone before giving ergonovine or methylergonovine.
■ Assess effectiveness of uterine massage and oxytocin administration on local flow and uterine
tone.
■ Recognize that these two drugs have a vasoconstrictive effect, which may cause hypertension.
Ergonovine is more vasoconstrictive than methylergonovine.
■ Obtain baseline BP before administration.
Nursing Interventions
■ Monitor patient’s BP per agency protocol.
■ Protect drugs from exposure to light.
■ Monitor for side effects or symptoms of ergot toxicity (ergotism). Notify health care provider if
systolic BP increases by 25 mm Hg or diastolic BP by 20 mm Hg over baseline.
Patient Teaching
■ Advise patient that she will feel more intense uterine cramps after receiving drug but may receive
analgesics for pain.
■ Encourage patient to avoid smoking. Nicotine increases vasoconstrictive properties of these drugs.
Side Effects
■ If patient is breastfeeding, explain that drug lowers serum prolactin levels with potential to inhibit
postpartum lactation. Ergonovine has greater potential to inhibit lactation than methylergonovine.
Evaluation
■ Evaluate effectiveness of drug by assessment of lochia and uterine tone. Count and weigh
perineal pads as appropriate.
■ Continue monitoring maternal vital signs, specifically pulse and BP. Report changes in maternal
vital signs, continued excessive vaginal bleeding, or uterine atony.