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Ergotism is defined as intense arterial vasoconstriction that produces signs and symptoms of ischaemia in the extremities or other tissues (such as renal or cerebral vasospasms). Gangrene is possible if it is not treated. Most cases of ergotism are related to chronic intoxication and/or overdose and/or an interaction.
Symptoms: Abdominal pain, confusion, light-headedness, nausea, vomiting, headache, tachycardia or bradycardia associated with hypotension, respiratory disorders, dizziness, paresthesia, ischaemia, gangrene, seizure, shock, coma, as well as symptoms of vascular ischaemia, such as numbness, tingling, pain in the extremities, cyanosis and absence of pulse. In rare cases, patients may present myocardial infarction.
Treatment: In the case of orally ingested drug, administration of activated charcoal is recommended. In the case of very recent oral intake gastric lavage may be considered.
Treatment should be symptomatic. In the event of severe vasospastic reactions, intravenous administration of a peripheral vasodilator such as nitroprusside, phentolamine or dihydralazine, local application of warmth to the affected area and nursing care to prevent tissue damage are recommended. In the event of coronary constriction, appropriate treatment such as nitroglycerin should be initiated.
