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PubMed2001

A simple thin-layer chromatographic method for the detection of ergovaline in leaf sheaths of tall fescue (Festuca arundinacea) infected with Neotyphodium coenophialum.

A relatively simple and inexpensive thin-layer chromatographic (TLC) method is described for the detection and semiquantitative measurement of ergovaline in leaf sheaths of tall fescue (Festuca arundinacea). Samples were finely ground and extracted with methanol. The extracts were filtered and the methanol was evaporated. The aqueous residue was extracted with hexane, followed by chloroform at pH 9. The chloroform extract was concentrated and further purified on a preparative silica gel TLC plate, developed with toluene/ethyl acetate/acetonitrile (50:10:40). The ergovaline band was scraped and eluted with methanol. The eluant was concentrated and an aliquot was applied to a silica gel TLC plate. The plate was developed successively with chloroform/acetone/acetic acid (90:10:5) and chloroform/ethanol (9:1). Ergovaline was visualized with p-dimethylaminobenzaldehyde and sulfuric acid. Semiquantitation of ergovaline was achieved by comparison with a known standard of ergotamine, which was shown to have the same Rf as ergovaline in this system. Spike recovery of ergotamine averaged 60%, with a limit of detection of 200 microg/kg of dry tall fescue leaf sheaths. The method was applied to 15 tall fescue samples with varying degrees of fungal infection, and ergovaline was identified in all contaminated samples with endophyte infection above 15%. Thin-layer chromatography may be also applicable for tall fescue seed, where the ergovaline content is usually higher and the amount of interfering pigments is much lower.

Acremonium↗

PubMed1980

Antimigraine drugs and cranial arteriovenous shunting in the cat.

The effects of three antimigraine drugs--ergotamine, dihydroergotamine, and methysergide--on the distribution of flow throughout the cephalic circulation of the cat were studied, using microspheres of a suitable size to separate capillary flow from flow through the arteriovenous anastomoses. Ergotamine and dihydroergotamine significantly decreased the fraction of carotid blood flow shunted through the arteriovenous anastomoses, a mode of action that reemphasizes the need for further clinical studies on the involvement of arteriovenous anastomoses in the pathophysiology of migraine headaches.

Animals↗

PubMed1998

A practical guide to the management and prevention of migraine.

Migraine is a paroxysmal disorder with attacks of headache, nausea, vomiting, photo- and phonophobia and malaise. Mild migraine attacks are treated with antiemetics followed by analgesics such as aspirin (acetylsalicylic acid), paracetamol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs). Moderate to severe attacks are treated by antiemetics combined with ergotamine or dihydroergotamine. Sumatriptan, a specific serotonin 5-HT1B/D receptor agonist, is used if attacks do not respond to ergotamine or if intolerable adverse effects occur. The new migraine drugs zolmitriptan, naratriptan, rizatriptan and eletriptan differ in their pharmacological profile from sumatriptan, but this translates into only minor differences in efficacy, headache recurrence and adverse effects. Migraine prophylaxis should be implemented when more than 3 attacks occur per month, if attacks do not respond to acute treatment or if the adverse effects of acute treatment are severe. Substances with proven efficacy include the beta-blockers metoprolol and propranolol and the calcium antagonist flunarizine. Drugs less effective or those with unpleasant adverse effects are the serotonin receptor antagonists (pizotifen, methysergide and lisuride), dihydroergotamine, cyclandelate, NSAIDs, valproic acid (sodium valproate) and amitriptyline. The efficacy of aspirin or magnesium is still under evaluation.

Analgesics↗

PubMed1992

Effects of hydrated sodium calcium aluminosilicate on fescue toxicosis and mineral absorption.

The possibility of supplementing livestock diets with an aluminosilicate to protect them from fescue toxicosis was investigated. An in vitro study showed that hydrated sodium calcium aluminosilicate (HSCAS) removed greater than 90% of the ergotamine from aqueous solutions at pH 7.8 or lower, indicating a high affinity of ergotamine for HSCAS in vitro. Rats fed diets containing tall fescue seed infested (E+) with the endophytic fungus Acremonium coenophialum had lower (P less than .05) feed intakes and weight gains than did rats fed diets containing uninfested (E-) tall fescue seed. When feed intake by rats fed the E- seed diet was limited to that of rats fed the E+ seed diet, weight gains did not differ, but testes weights and serum prolactin (PRL) concentrations were lower (P less than .05 and .10, respectively) in rats receiving E+ seed. Supplementing E+ seed diets with HSCAS did not eliminate effects of E+ seed on intake, PRL, or testes weights. Sheep fed E+ tall fescue hay had higher (P less than .05) rectal temperatures than did sheep fed an equal amount of E- tall fescue hay, but OM and N digestion coefficients did not differ between the two hays. Supplementing E+ hay diets with HSCAS did not eliminate the effect of E+ hay on rectal temperatures. Addition of 2% HSCAS to tall fescue hay diets did not affect apparent absorption by sheep of OM, N, Ca, P, Na, K, or Cu, but it reduced (P less than .05) the apparent absorption of Mg, Mn, and Zn.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗

PubMed1999

[Intractable vomiting, convulsions and megaloblastic anemia: anamnesis, key to diagnosis].

In July 1996 a 43-year-old illiterate Hispanic woman presented with uncontrollable vomiting, palpitations and confusion. In 1994, despite several hospitalisations in other medical centres where a cerebral CT-scan, oesogastroduodenoscopy, colonoscopy and abdominal ultrasound were performed, no satisfactory diagnosis could be found. A psychiatric origin was finally considered. On admission, the laboratory findings showed severe metabolic alkalosis with associated hypokalaemia, confirmatory evidence of vomiting. The ECG showed tremendous P waves (5 mV) in the standard derivations, which can be explained by the hypokalaemia, with multiple supraventricular extrasystoles. Echocardiography and pulmonary scintigraphy ruled out pulmonary hypertension and a pulmonary embolus. After additional discussion with her daughter we discovered that the patient had been treating chronic headaches for years with 4-5 Cafergot-PB suppositories per day. This drug contains 2 mg ergotamine tartrate, 100 mg butalbital, 100 mg caffeine and 0.25 mg belladona alkaloids. As is known, vomiting is a classical symptom of ergotamine intoxication. After rehydration we discovered a megaloblastic anaemia with a folate deficiency compatible with chronic barbiturate intoxication. Folate and iron supplementation allowed a rapid normalisation of the haemoglobin values. Five months after having stopped the Cafergot-PB, the patient was well and did not vomit anymore. The headaches were treated with chlorpromazine with a good result. Despite sophisticated technical means, the diagnosis could only be established after a thorough history taking. This message should be heard in times when high tech medicine tends to obscure the place of a good history taking!

Adult↗

PubMed1998

Does nitric oxide participate in the mechanism of action of dotarizine?

Behavioral and nociceptive effects of dotarizine (DOT) and other substances acting on migrainous attacks and nitric oxide (NO) metabolism were studied in comparative experiments on rats. Behavioral effects were evaluated by the changes induced in ambulations and rearings of rats in the Opto-Varimex apparatus; effects on nociception were determined by the changes of pain threshold in growing mechanical pressure on one of the rat paw. The data showed that (1) NO did not participate directly in the mechanism of the behavioral actions of DOT. A role could be ascribed to the modulating influence of DOT on the changes in NO formation induced by other agents; (2) the NO system did not participate in the mechanisms of the responses to the painful mechanical pressure on the rat paw; (3) the behavioral effects of the substances with facilitating or inhibitory action on the migrainous process (m-CPP and ergotamine) and the influence of substances proved to affect NO formation (L-arginine, histamine, L-NAME) on these effects suggest a role for NO as a modulating but not a basic factor in the mechanisms of action of these pro- and antimigrainous substances; and (4) the behavioral effects of DOT were similar to the effects of the antimigrainous drug ergotamine and different from the promigrainous drug meta-chlorophenyl-piperazine (m-CPP)--which suggest an antimigrainous activity of dotarizine.

Animals↗

PubMed2000

Manifold manifestations of ergotism.

Vasospastic side effects leading to organic manifestations are rare in ergotamine therapy. To our knowledge, combinations of more than two signs of ergotism have rarely been described in the literature so far. We present a 65-year-old male patient who as a consequence of severe migraine had developed ergotamine abuse. He was admitted to our hospital after one week of increasing abdominal pain. During laparotomy, necrotic areas of the small intestine and the sigmoid colon were resected, which on histopathologic examination revealed severe hypertrophy of the smooth musculature of mesenteric arteries, resulting from chronic vasospasms. Postoperatively, the patient developed ischaemia of the limbs which was confirmed by angiography. Before death, the patient also showed ischaemic signs in the acrae and necrosis of the tongue.

Aged↗

PubMed2000

[Conserved ergot-sensitive subunit of the central mechanism of locomotion in mollusca].

Alkaloids (ergotamine and ergometrine) were shown to slow down rhythmic locomotion in even distantly related molluscs. The same is true for crawling pulmonate, pond snail Lymnaea stagnalis. The ergotamine activation of a powerful inhibitory input to pedal neurones involved in locomotor rhythmicity, was shown. The data obtained suggest that the conservative target for ergots is located outside rather than within the central pattern generator for locomotion.

Animals↗

PubMed1989

Cluster headaches.

The patient with cluster headaches will be afflicted with the most severe type of pain that one will encounter. If the physician can do something to help this patient either by symptomatic or, more importantly, prophylactic treatment, he or she will have a most thankful patient. This type of headache is seen most frequently in men, and occurs in a cyclic manner. During an acute cycle, the patient will experience a daily type of pain that may occur many times per day. The pain is usually unilateral and may be accompanied by unilateral lacrimation, conjunctivitis, and clear rhinorrhea. Prednisone is the first treatment we employ. Patients are seen for follow-up approximately twice a week, and their medication is lowered in an appropriate manner, depending on their response to the treatment. Regulation of dosage has to be individualized, and when one reaches the lower dose such as 5 to 10 mg per day, the drug may have to be tapered more slowly, or even maintained at that level for a period of time to prevent further recurrence of symptoms. We frequently will use an intravenous histamine desensitization technique to prevent further attacks. We will give the patient an ergotamine preparation to use for symptomatic relief. As these patients often have headaches during the middle of the night, we will place the patient on a 2-mg ergotamine preparation to take prior to going to bed in the evening. This often works in a prophylactic nature, and prevents the nighttime occurrence of a headache. We believe that following these principles to make the accurate diagnosis and institute the proper therapy will help the practicing otolaryngologist recognize and treat patients suffering from this severe pain.

Calcium Channel Blockers↗

PubMed1985

[Severe arterial spasm and secondary thromboses of the limbs in chronic ergotism].

A 40 year old woman who took a daily dose of 2-4 mg of Ergotamine Tartrate (Cafergot) regularly for 6 years to combat persistent migraine, was treated for a non-atherosclerotic arterial disease, severe arteriospasm of the great limb arteries, hyperplasia of the intima and segmental thrombosis. Binding of adrenergic alpha and beta receptors was investigated. Surprisingly it was found that the number of adrenergic beta receptors was significantly lower thant that of a healthy woman of the same age used as a control while the number of alpha receptors was not significantly different. This action of ergotamine on beta receptors could be explained by a dopamine-mimetic stimulation, due to the central nervous system, that could lead to the preferential regulation of beta receptors rather than alpha receptors, almost as a protective mechanism of alpha receptors.

Adult↗

PubMed1986

[Conduction velocity and relative refractory period of the sural nerve in patients treated with ergot alkaloids].

Relative refractory period and sural nerve conduction velocity were estimated in 30 probands and 52 patients treated with ergotamine tartrate using surface electrodes. A significant reduction in sural nerve relative refractory period could be correlated to an ergotamine dosage limited within therapeutical range. Patients under treatment without complaints even had a significant shorter relative refractory period compared to patients suffering from dysesthesia (p less than 0.01). Sural nerve conduction velocity showed a similar but not significant change in the tested patients.

Adult↗

PubMed1978

[Short-term localized myocardial ischaemia and its consequences in Prinzmetal angina pectoris (author's transl)].

In a 45-year-old female patient with Prinzmetal angina pectoris coronary angiograms and a 201thallium scintigram were performed during an ergotamine-induced episode of angina. The spontaneous and the ergotamine-induced attacks were characterized by transient ST elevation in the posterior wall ECG leads. The coronary angiogram during the attack showed spasm of the circumflex branch of the left coronary artery. In the 201thallium scintigram a large defect in myocardial thallium uptake was noticed in the posterior wall of the left ventricle. Angina and ECG abnormalities disappeared within 4 minutes. However, the scintigraphic defect disappeared only after 6 hours. The slow recovery of myocardial thallium uptake is thought to represent an alteration of the myocardium after a brief 4 minute interruption of regional coronary arterial blood flow. The diagnostic approach in patients with Prinzmetal angina is discussed.

Angina Pectoris↗

PubMed1981

Adrenergic drug effects on aqueous outflow facility following ciliary muscle retrodisplacement in the cynomolgus monkey.

Cynomolgus monkeys with untouched, totally iridectomized, or totally iridectomized and ciliary muscle-disinserted eyes underwent two-level constant-pressure perfusion of the anterior chamber to determine the effect of intracameral mock aqueous humor, l-epinephrine bitartrate (10 microgram), l-norepinephrine bitartrate (10 microgram), ergotamine tartrate (1 and 20 microgram), and angiotensin II amide (1 and 100 microgram) on total outflow facility. Ergotamine and angiotensin both tended to decrease facility. Epinephrine and norepinephrine significantly increased facility, approximately 25% and 40%, respectively, beyond the effect of mock aqueous in all three types of eyes. The percentage increases in facility produced by epinephrine and norepinephrine were virtually identical in disinserted and nondisinserted eyes and were independent of starting facility in the individual eyes. Our results prove that the epinephrine- and norepinephrine-induced facility increase in cynomolgus eyes is not mediated by the iris or ciliary muscle and suggest that the increase in total facility is due largely to increased facility across the trabecular meshwork.

Angiotensin Amide↗

PubMed1978

Studies on the 5-HT receptor in vascular smooth muscle.

Changes in tension were monitored isometrically on spiral strips of freshly obtained bovine basilar arteries. Ergotamine (E), dihydroergotamine (DHE), methysergide (M) and pizotifen (BC-105) displaced the concentration-response curve for 5-HT in a noncompetitive way and in similar concentration ranges as indicated by the pD' 2(60 min) values of the three ergot alkaloids (E: 9.2, M: 9.1, DHE: 8.8) and the pD' 2(30 min) value (8.9) of BC-105. The ergot alkaloids but not BC-105 also exhibited considerable stimulating activity. The calculated pD2 values were 8.8 for E, 8.6 for DHE and 6.6 for M. Relative to 5-HT (= 1) the intrinsic activities were 0.4, 0.2 and 0.1 for E, DHE and M, respectively. BC-105 was nearly equipotent in antagonizing responses to 5-HT, E and DHE suggesting that both ergot alkaloids act as noncompetitive dualists at the 5-HT receptor. The results suggest that the strong stimulant rather than the blocking activity at the 5-HT receptor of ergotamine may be an important property for its therapeutic efficacy in migrainous attacks.

Animals↗

PubMed1978

[Iatrogenic ergotism. Apropos of a case].

A 36 year-old woman was given Ergotamine Tartrate 4.5 mg p.d. during seven days, after an abortion (a still birth). Subsequently she developed a generalised arterial spasm of the limbs producing a feet necrosis. A transmetatarsal amputation was performed. This observation and 63 others cases in the litterature call attention to the potential dangers of the ergot derivatives (ergotamine tartrate), even at normally accepted therapeutic doses. Arteriolar thrombosis and subsequent tissular gangrene can be presented by early administration of heparin, dextran infusions and, possibles, hyperbaric oxygen. Among the vasodilatation drugs, only sodium nitroprussiate seems to be effective.

Adult↗

PubMed1980

[Value of lower limb arteriography in iatrogenic ergotism. A report on a case (author's transl)].

The authors report a further case of ergotamine poisoning with acute ischemia of the four limbs. Arteriography was carried out during the course of the vascular accident and at a later period when clinical signs had disappeared. Arteriography confirmed the presence of diffuse vascular spasm appearing as thin filiform arteries without any signs of a collateral circulation. Normal conditions were restored in the iliac, femoral, and leg arteries after stopping ergotamine administration. Arteriography appears to be of great value when there is any doubt during the acute clinical stage, in order to assist diagnosis and to confirm and verify the integrity of the vascular network at a later stage.

Ergotamine↗

PubMed1995

Effect of isocarbacyclin methyl ester incorporated in lipid microspheres on experimental models of peripheral obstructive disease.

The effect of TTC-909 (isocarbacyclin methyl ester (CAS 88931-51-5, TEI-9090) incorporated into lipid microspheres) on obstruction of the peripheral artery was studied in two different animal models. The first was a peripheral occlusion model induced by intra-arterial injection of sodium laurate in rats. The second was a tail gangrene model induced by subcutaneous injection of both ergotamine and epinephrine in rats. Intravenous bolus-administered TTC-909 at 1.0 microgram/kg resulted in the inhibition of both progression of lesions induced by sodium laurate and the extension of tail gangrene by ergotamine and epinephrine. Moreover, the inhibitory effect of TTC-909 was more potent than that of PGE1 (LM) (prostaglandin E1 incorporated into lipid microspheres). These findings suggested that TTC-909 may be clinically useful for the therapy of peripheral vascular disorders such as thromboangiitis obliterans (TAO) and atherosclerosis obliterans (ASO).

Alprostadil↗

PubMed1993

Recent advances in migraine management.

Migraine periodically disables millions of Americans and thus has a significant economic impact on society. Successful treatment of migraine requires that the physician understand the pathophysiology underlying migraine and educate the migraineur in the management of this chronic pain syndrome. Recent advances in the receptor biochemistry of serotonin have given important insight into the mechanisms of migraine pain and treatment. An understanding of these mechanisms has resulted in treatment strategies that address the mechanism of headache control rather than just symptom control. Advances in pharmacologic therapy include a newly developed highly selective serotonin agonist called sumatriptan, which appears to be a promising addition to the armamentarium of abortive migraine treatments. Further data correlating the role of daily analgesics and ergotamines in transforming episodic migraine into chronic daily headache represent another significant advance in migraine management. Clinical trials of sumatriptan are reviewed, and the role of daily analgesic and ergotamine use is discussed in relation to advances in migraine pathophysiology and available demographic data on migraine.

Analgesics↗