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(err-GO-loyd- MEH-suh-lates)
Gerimal, Hydergine, Hydergine LC, Niloric
Class: Psychotherapeutic

 Action Unknown; may increase brain metabolism, possibly increasing cerebral blood flow.

 Indications Treatment of age-related decline in mental capacity, primary progressive dementia, Alzheimer’s dementia, multi-infarct dementia and senile onset.

 Contraindications Hypersensitivity to ergoloid mesylates or other ergot alkaloids; acute or chronic psychosis.

 Route/Dosage

ADULTS: PO/SL 1 to 2 mg tid (up to 12 mg/day has been used).

 Interactions None well documented.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Orthostatic hypotension; bradycardia. DERM: Rash. GI: Transient nausea; GI disturbances; sublingual irritation.

 Precautions

Pregnancy: Pregnancy category undetermined. Lactation: Undetermined. Children: Safety and efficacy not established. Special risk patients: Administer drug with caution to patients with history of bradycardia or hypotension. Liver impairment: Elimination of drug may be affected.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Instruct patient to allow SL tablets to completely dissolve under tongue; do not allow patient to swallow, crush or chew tablet.
  • Do not permit patient to eat, drink or smoke while SL tablet is dissolving.
  • Store in tightly closed, light-resistant container at room temperature.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Potentially reversible and treatable conditions should be ruled out prior to use of ergoloid mesylates in treating age-related decline of mental capacity.
  • Assess patient’s mental status (alertness, memory, orientation, mood, emotional liability and self-care) prior to and during administration of drug.
  • Monitor BP and pulse rate prior to initiation of therapy and at periodic intervals during therapy.
  • Take appropriate safety measures if lightheadedness, weakness or changes in mental status develop.
OVERDOSAGE: SIGNS & SYMPTOMS
  Headache, flushing, anorexia, nausea, vomiting, abdominal cramps, nasal congestion, impaired vision, dizziness, fainting

 Patient/Family Education

  • Teach patient how to decrease effects of orthostatic hypotension by rising slowly from supine position and dangling feet for few min before standing.
  • Instruct patient to avoid alcohol consumption, which may enhance hypotensive effect.
  • Caution patient not to take otc cough, cold and allergy preparations that contain alcohol.
  • Instruct patient to avoid excessive exposure to cold since temperature regulation may be impaired.
  • Instruct patient to notify physician if adverse reactions occur.
  • Advise patient/family that it may require 3–4 wk and up to 6 mo to determine clinical effectiveness of drug.

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