magnesium sulphate in obstetrics

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MAGNESIUM SULPHATE : 

MAGNESIUM SULPHATE BY ROSEMARY PALMER RN, RM, BSc Hons (Sport science & administration), ADM

ACTION : 

ACTION Magnesium is essential for functioning of many enzymes –neurotransmission & muscle excitability

PRESENTATION & STORAGE : 

PRESENTATION & STORAGE 1 gram in 2 ml vial Store BELOW 25 oC

INDICATIONS FOR USE : 

INDICATIONS FOR USE Treatment for eclampsia Prophylactic treatment for pre-eclampsia (proteinurc) Prophylactic treatment for imminent eclampsia Can also be used to stop contractions, for the treatment of Hypoxic Ischaemic Encephalopathy of neonates and nebulised for asthmatic treatment

CONTRAINDICATIONS : 

CONTRAINDICATIONS Impaired renal function –excreted via urine Heart block or myocardium malfunction Liver damage

SIDE EFFECTS : 

SIDE EFFECTS Rapid administration can lead to hypotension Facial flushing Nasal stuffiness Chest pain

OVERDOSE EFFECTS : 

OVERDOSE EFFECTS Loss of tendon reflexes Respiratory Depression Drowsiness Cardiac arrythmia and cardiac arrest –rapid infusion requires ECG monitoring and anaesthetist.

ANTIDOTE : 

ANTIDOTE Calcium Gluconate 10% slution ( 1 vial) 10ml IVI slowly

DOSAGE : 

DOSAGE For imminent eclampsia/ pre-eclampsia / eclampsia DISTRICT: (because limited monitoring): 5g (10ml) IMI in each buttock and 4g (8ml) in 200ml NaCl to run over 15-20 minutes. (14g total) 2nd LEVEL: 6g IV slow bolus the 8g in 200ml NaCl via IVAC @ 54ml /hr (14g) Maintenance is 5g IMI alternate buttocks 4hourly x 24 hours. DO NOT GIVE ANY OTHER DRUG IV VIA SAME LINE

FOR ECLAMPTIC CONVULSIONS : 

FOR ECLAMPTIC CONVULSIONS Give 4mg bolus (8ml) over 5-10 minutes then continue maintenance as above. Priority is to terminate convulsion. Mum comes first Depends on protocol in place . Mag Sulp does control convulsion so don’t give clonazepam unless very restless

MONITORING : 

MONITORING Urine output >30ml per hour –if not can cause magnesium toxicity & renal damage and dosage needs reducing. Reflex monitoring, GCS monitoring For IV route must have ECG monitoring available