After taking some drug for acute attack of migraine, a patient developed nausea and vomiting. He also developed tingling and numbness in the tip of the finger that also turned blue. Which of the following is the most likely drug implicated in causing the above findings
Ergotamine:- Mech of action:- It acts as a paial agonist and antagonist at a adrenergic and all subtypes of 5-HT1 and 5-HT2 receptors. It produces sustained vasoconstriction(leading to Acrocyanosis), visceral smooth muscle contraction, vasomotor centre depression and antagonizes the action of NA and 5-HT on smooth muscles. It is a potent emetic (through CTZ and vomiting centre) and moderately potent oxytocic. At high doses CNS stimulation and paresthesias may be experienced. On chronic exposure (ergot poisoning) vasoconstriction is accompanied by damage to capillary endothelium--thrombosis, vascular stasis and gangrene. Ref:- kd tripathi; pg num:-175,176
Ergotamine
Aspirin
Sumatriptan
Butorphanol
Autacoids