A 50-year-old woman was admitted to the hospital with severe peripheral ischemia of all four extremities due to an overdose of suppositories containing ergotamine tartrate and caffeine (Cafergot) (total dose of ergotamine, 36 mg). Fluids were given intravenously but, because of recurrent seizures, anticoagulants were not given. Signs of ischemia increased and were unaffected by intravenously given hydralazine hydrochloride. A continuous intravenous infusion of the potent vasodilator sodium nitroprusside was then initiated, with subsequent complete resolution of all signs and symptoms of peripheral ischemia.
Carliner NH, Denune DP, Finch CS, Goldberg LI. Sodium Nitroprusside Treatment of Ergotamine-Induced Peripheral Ischemia. JAMA. 1974;227(3):308–309. doi:10.1001/jama.1974.03230160036008
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