Methergine (Maternal) Drug Study

Generic Name: Methergine
Brand name: Methylergonovine Maleate
Pharmacologic: ergot alkaloids
Availability Tablets: 200 mcg (0.2 mg).Injection: 200 mcg (0.2 mg)/ml in 1-ml ampules.

Action
Methylergonovine maleate(methergine) is an ergot alkaloid that stimulates smooth muscle tissue. Because the smooth muscle of the uterus is  especially sensitive to this drug ,it is used postpartally to stimulate the uterus to contract in order to decrease blood loss by clamping off uterine blood vessels and to promote the involution process. In addition, the drug has vasoconstrictive effect on all blood vessels,especially the larger arteries.

Route,Dosage,Frequency
Methergine has a rapid onset of action and may be given orally or intramuscularly.
Usually IM dose: 0.2 mg following expulsion of the placenta.The dose may be repeated every 2-4 hours if necessary.
Usual oral dose: 0.2 mg every 4 hours (six doses)

Maternal Contraindications
Pregnancy,hepatic or renal disease, cardiac disease, hypertension or preeclampsia contraindicate this drugs use.Methylergonovine maleate must be used with caution during lactation.

Maternal Side Effects
Hypertension,nausea,vomiting,headache,brandycardia,dizziness,tinnitus,abdominal cramps,palpitations,dyspnea,chest pain and allergic reactions may be noted.

Nursing Implications

• Monitor fundal height and consistency and the amount and character of the lochia.
• Assess the blood pressure before and routinely throughout drug administration.
• Observe for adverse effects or symptoms of ergot toxicity(ergotism) such as nausea and vomiting,headache,muscle pain,cold or numb fingers and toes,chest pain and general weakness.

Patient /Family Teaching

• Instruct patient to take medication as directed; do not skip or double up on missed doses. If a dose is missed, omit it and return to regular dose schedule.
• Advise patient that medication may cause menstrual-like cramps
• Caution patient to avoid smoking, because nicotine constricts blood vessels.
• Instruct patient to notify health care professional if infection develops, as this may cause increased sensitivity to the medication.

Credits:
Contemporary Maternal Newborn Nursing Care sixth edition
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