Ocular ergotamine tartrate toxicity during treatment of Vacor-induced orthostatic hypotension

A 20-year-old woman developed severe orthostatic hypotension after attempting suicide by ingesting the rodenticide, Vacor. Oral ergotamine tartrate, 6 mg a day, was useful in treating the orthostatic hypotension. However, a bilateral toxic retinal vasculopathy, consisting of a severe generalized vasoconstriction and mild macular edema, occurred within three weeks. Additional findings were an extinguished electroretinogram and a reduced dark-adaptation retinal sensitivity; because we performed these two tests after instituting ergotamine therapy we do not know whether to attribute their abnormal results to Vacor toxicity, ergotamine toxicity, or a combination of the two.     

Dietary management of patients in chronic renal failure]

A new oral amino acid preparation was given to two groups of patients: group 1, five patients on hemodialysis; and group 2, five patients with chronic renal failure (CRF). In group 1 significant pre- and postdiet changes were: BUN 93-37 mg% (p smaller than 0.01); creatinine 13.0-9.7 mg% (p smaller than 0.001); phosphorus 6.6-4.2 mg% (p smaller than 0.05); uric acid 8.7-6.0 mg% (p smaller than 0.01); CO2 16.3-21.3 mEq/I (p smaller than 0.01); hematocrit 18.0-20.8% (p smaller than 0.05). In group 2: BUN 93-66 mg% (p smaller than 0.05); phosphorus 5.6-3.8 mg% (p smaller than 0.05); hematocrit 27.3-30.7% (p smaller than 0.05). Nitrogen balance was positive in all patients. It is concluded that this oral amino acid mixture is well-tolerated and can be utilized in CRF to attain protein anabolism.