magnesium sulfate

http://www.thewomens.org.au/MagnesiumSulphate

Magnesium sulphate is the anticonvulsant of choice for pre-eclampsia prophylaxis and treatment.

Indications for use
·         magnesium sulphate is used in pregnancy for women with pre-eclampsia for whom there is concern about the risk of eclampsia firstline management of an eclamptic seizure neuroprotection of preterm infants.
·           ·           ·         Contraindication: ·           ·         Magnesium sulphate should be administered with caution in women being treated with cardiac glycosides/digitalis. ·           ·         Concurrent use of magnesium sulphate and CNS depressants may result in an enhanced CNS depressant effect.
·         If calcium gluconate is required to treat magnesium sulphate toxicity, it should be delivered with caution as it may precipitate heart block.
·         As magnesium is excreted in urine, patients with impaired renal function or electrolyte imbalance should be managed cautiously and magnesium levels should be monitored closely because of the increased risk of magnesium toxicity.
Mg conc (mmol/L)	Effects
0.8 - 1.0	normal plasma level
1.7 - 3.5	therapeutic range
2.5 - 5.0	ECG changes (P-Q interval prolongation, widen QRS complex)
4.0 - 5.0	reduction in deep tendon reflexes
> 5.0	loss of deep tendon reflexes
> 7.5	sinoatrial and atrioventricular blockade. Respiratory paralysis and CNS depression
> 12	cardiac arrest