Mgso4 Drug Study
Mgso4 Drug Study
Mgso4 Drug Study
NURSING
DRUG STUDY ON :-
Magnesium sulphate
J.I.N.S.A.R.
MAGNESIUM SULPHATE
CLINICAL PHARMACOLOGY:-
ACTION:
Decreases acetylcholine in motor nerve terminals, which is responsible for anticonvulsant properties,
thereby reduce neuromuscular irritability. Ti also decreases intracranial edema and helps in dieresis.
Its peripheral vasodilation effect improves the uterine blood supply. Has depressant action on the
uterine muscle and CNS.
INDICATIONS
3) Single dose regime like VIMS regimes. Whatever the regimes is, delivering the drug
intravenously is the most preferred method and the duration of treatment should not normaly
exceed 24 hours.
1) The traditional Pritchard's Regime has been used for 55 years since 1955.The Pritchard's
regimes involves
Loading dose
4g IV, slow bolus (not less than 3 minutes) followed by 5g IM in each buttock
If convulsion persists over 15 minutes, 2g is given over 2 minutes.
Maintenance dose
5g IM every 4 hourly at alternate sites. Play particular attention to knee reflex, respiratory
rate and urine output.
Loading dose
Maintenance dose
Study shows than Zuspan's regime is eight times less effective than Pritchard's regime in the
prevention of convulsion in pre eclampsia and eclampsia. Maternal mortality was 2.5 times
greater in women who received Zuspan's regimen than among those on Pritchard's regimen.
Even so, current study shows that seizure can be safely controlled in women with eclampsia
with a lower dose of MgSO4, with the advantage of a lower magnesium toxicity. It therefore
seems that a lower dose of MgSO4 can be safely used at peripheral institutions where
facilities for proper monitoring are lacking.
Loading dose
IV MgSO4 4g, slow bolus over 10-15 minutes to prevent cardiac arrest.
Maintenance dose
IV 1g/hour MgSO4.
If convulsion persist after 15 minutes, a further 2g MgSo4 diluted in 6 ml normal saline or sterile
water is given over 15 minutes.
SIDE EFFECTS:-
Maternal:-
ECG changes (prolongation of the atrio-ventricular conduction time, sinoatrial block and
atrio-ventricular block).
Circulatory collapse, hypotension.
Gastrointestinal disturbances (diarrhoea, abdominal distension, absence of bowel sounds).
Urinary retention.
CNS depression (central sedation, muscle relaxation, hyporeflexia and decreased
excitability).
Calcium and potassium disturbances.
Respiratory depression.
Fetal:-
Tachycardia
Hypoglycaemia.
SPECIAL CONSIDERATIONS
NURSING CONSIDERATIONS:-
Fetal assessment:-
ASSESS:-
Vital signs after 15 min after IV dose. Do not exceed 150 mg/ min.
Monitor magnesium levels.
If using during labour time contractions, determine intensity.
Urine output should remain 30 ml/hr or more, if less notify physician.
Uterine contractions when used as tocolytic agents.
Reflexes- knee jerk, patellar reflex.
ADMINISTER:-
PERFORM / PROVIDE
Seizure precautions: place client in single room with decreased stimuli, padded side
rails.
Positioning of client in left lateral recumbent position to decrease hypotension and
increase renal blood flow.
EVALUATE:-
One all aspects of the drug: action, side effects and symptoms of hypermagnesemia.
To remain in bed during infusion.
CONCLUSION
Magnesium sulphate has been used in the treatment of eclampcia in north America for many
year. There is no consensus as to the dosing regimen , but care should be taken to avoid
magnesium toxicity.
BIBLIOGRAPHY