informative exhibits 1993 ACEP scientific assembly

D.H.E. 45:, (dihydroergotamine mesylate) injection, USP DESCRIPTION D.H.E. 45® is hydrogenated ergotamine as the mesylate. It is a clear, colorless, stable ampul solution containing per mL: dihydroergotamine mesylate, ueP . . . . . . . . . . . . . ling methanesulfonic acid/sodium hydroxide . . . . . . . . . qs to pH 3.6 ± 0.4 alcohol, USP . . . . . . . . . . . . . . . . . . . . . . . . 6.1% by voL glycerin, USP . . . . . . . . . . . . . . . . . . . . . . . . . 15% by wt. water for injection, USP, qs to . . . . . . . . . . . . . . . . 1 mL ACTIONS Dihydroergotamine is an alpha adrenergic blocking agent with a direct stimuJating effect on the smooth muscle of peripheral and cranial blood vessels, and produces depression of central vasomotor centers. The compound also has the properties of serotonin antagonism. In comparison to ergotamine, the adrenergic blocking actions are more pronounced, the vasoconstrictive actions somewhat less pronounced, and there is reduced incidence and degree of nausea and vomiting. Onset of action occurs in 15 to 30 minutes following intramuscular administration and persists for 3-4 hours. Repeated dosage at 1 hour intervals up to 3 hours may be required to obtain maximal effect. INDICATIONS As therapy to abort or prevent vascular headache, e.g., migraine, migraine variants, or so-called "histaminic cephalalgia" when rapid control is desired or when other routes of administration are not feasible. CONTRAINDICATIONS Peripheral vascular disease, coronary heart disease, hypertension, impaired hepatic or renal function, sepsis and pregnancy Hypersensitivity ADVERSE REACTIONS Numbness and tingling of fingers and toes, muscle pains in the extremities, weakness in the legs, precordial distress and pain, transient tachycardia or bradycardia, nausea, vomiting, localized edema and itching. There have been reports of pleural and retroperitoneal fibrosis in patients following prolonged use of dihydroergotamine. DOSAGE AND ADMINISTRATION For vascular headache, 1 mL intramuscularly at first warning sign of headache, repeated at 1 hour intervals to a total of 3 mL. Optimal results are obtained by titrating the dose for several headaches to find the minimal effective dose for each patient and this dose should then be employed at onset of subsequent attacks. Where more rapid effect is desired, the intravenous route may be employed to a maximum of 2 mL. Total weekly dosage should not exceed 6 mL OVERDOSAGE Failure to observe the upper limits of repeated parenteral dosage may result in eventual onset of the peripheral toxic signs and symptoms of ergotism. Treatment includes discontinuance of the drug, warmth, vasodilators, and good nursing care to prevent tissue damage. HOW SUPPLIED As a clear, colorless and stable solution in ampuls containing: dihydroergotamine mesylate, USP . . . . . . . . . . . . 1 mg methanesulfonic acid/sodium hydroxide . . . . . . . . . qs to pH 3.6 ± 0.4 alcohol, USP . . . . . . . . . . . . . . . . . . . . . . . . 6.1% by vol, glycerin, USP . . . . . . . . . . . . . . . . . . . . . . . . . 15% by wt. water for injection, USP, qs to . . . . . . . . . . . . . . . . t mL Ampuls, 1 mL size - - boxes of 20. *Also known as Dyhydergot® SANDOZ PHARMACEUTICALS CORPORATIO N, East Hanover, New Jersey 07936 [JANUARY 15, 1992 DHE-Z21] REFERENCES 1. Goedsby PJ, Gundlach AL. Localization of 3Hdihydroergotamine-binding sites in the cat central nervous system: Relevance 1o migraine. Ann Neurol. 1991 ;29:91-94. 2. McCarthy BG, Peroutka SJ. Comparative neuropharmacology of dihydroergotamine and sumatriptan (GR 43175). Headache. 1989;29:420-422. 3. Belgrade M J, Ling LJ, Schleevogt MB, et al. Comparison of single-dose meperidine, butorphanof, and dihydroergotamine in the treatment of vascular headache. Neurology. 1989;39:590-592. 4. Raskin NH. Headache. 2rid ed. New York, NY: Churchill Livingstone; 1988:150-152. 5. Drugs used for headaches and neuralgias. AMA Drug Evaluations. 1991:129. 6. Raskin NH. Repetitive intravenous dihydroergotamine as therapy for intractable migraine. Neurology. 1986;36:995-997. DHE-0193-01 ]/93

Call for Educational/ Informative Exhibits 1993 ACEP Scientific Assembly

The ACEP Educational Meetings Committee has issued a call for educational/informative exhibits to be considered for presentation at the 1993 Scientific AssemNy in Chicago, Illinois, 0ctober 11-14, 1993. Marsha D. Ford, MD, FACEP, Chair of the Educational Meetings Committee, has set July 9, 1993, as the deadline for submission of notice of intent to present an educational/informative exhibit. Educational/informative exhibits may deal with any topic pertinent to emergency medicine. For example, exhibits may display new developments; demonstrate concepts or techniques; review important research findings; or share personal experiences relating to the practice of emergency medicine. Space will be limited. Exhibits may be sponsored only by an emergency medicine residency program; other 501(c)(6) or 501(c)(3) research/educational institution; or an individual. No specific product or commercial service may be represented or promoted. This exhibit session is not intended to function primarily as a forum for the presentation of original research results; however, exhibits that present preliminary data from research in progress may be considered for acceptance. Posters will not be accepted for presentation as educational/ informative exhibits. For presentation of original research, a separate area'is available for posters only. Poster presentations are not competitive.

Exhibits will be judged based on originality, presentation, educational value, and scientific content. Judges will be appointed by the Chair of the ACEP Educational Meetings Committee. The judgment of the Educational Meetings Committee is final. The winning exhibit will be presented with an appropriate citation and a cash award. Letters of intent and/or inquiries for information concerningeducational/informative exhibits should be submitted to: Exhibits Manager, ACEP, P.O. Box 619911, Dallas, Texas, 75261-9911.

ANNALS OF EMERGENCY MEDICINE

22:5

MAY 1993