[Systemic arterial spasms. Ergotamine tartrate].
The problem of the toxic effects of ergotism is raised by two cases of acute lower limb ischaemia observed in young patients. Although commonly encountered up to the 20th century, the problem is now reappearing sporadically from iatrogenic causes. The clinical features and treatment of ergotism are discussed. Prophylaxis is based on two main principles: the respect of contraindications, the most important being hypertension, coronary insufficiency, arteriopathies, acrocyanosis and thrombophlebitis, and less importantly, the association of tetracycline type antimicrobials, triacetyloleandomycin and phenothiazine; on the other hand, attention must also be paid to the instructions on its use, particularly with respect to the maximum dosage, 4 mg/day per os, 10 mg/week per os. The treatment should be given intermittently and not continuously. Full knowledge of the composition of composite drugs is required as many drugs are commercialised with their ergotamine content masked. This justifies, if there is still need, constant pharmacovigilance.