Precautions for magnesium sulfate in obstetrics

In obstetrics and gynecology, mothers will use some magnesium sulfate drugs. Because pregnant women are prone to pregnancy-induced hypertension or prenatal and postpartum diseases during pregnancy, magnesium sulfate plays an important role at this time. So, since pregnant mothers are in a special period, what issues should they pay attention to when using magnesium sulfate? Let us give a brief introduction today.

Precautions for use of magnesium sulfate injection

1. Before using magnesium sulfate injection, renal function must be checked. If renal function is impaired, it should be used with caution and the dosage should be reduced.

2. It should be used with caution or not at all in cases of myocardial damage or heart block.

3. Before and during each medication, check knee tendon reflex regularly, measure respiratory rate, observe urine output, and draw blood to check blood magnesium concentration. If knee tendon reflex is significantly weakened or disappears, or respiratory rate is less than 14-16 times per minute, urine output is less than 25-30 ml per hour, or less than 600 ml in 24 hours, the medication should be stopped immediately.

4. If chest tightness, chest pain, or shortness of breath suddenly occurs during medication, auscultation should be performed promptly and a chest X-ray should be taken if necessary to detect pulmonary edema as early as possible.

5. If acute magnesium poisoning occurs, calcium can be injected intravenously to relieve the patient. The commonly used one is 10% calcium gluconate injection 10 ml slowly injected.

6. During pregnancy preservation treatment, it is not advisable to use it simultaneously with adrenaline beta receptor agonists, such as ritodrine, otherwise it is easy to cause adverse cardiovascular reactions.

7. Use by pregnant and lactating women: Pregnant women should use it with caution as a laxative and lactating women should not use it.

8. For children: intramuscular or intravenous injection: 0.1-0.15 g/kg each time, for anticonvulsant use. When using, dilute this product with 5-10% glucose injection to a 1% solution and drip it intravenously, or dilute it to a 5% solution and slowly inject it intravenously. The 25% solution can be injected deeply into the muscle. Generally, pediatrics only use intramuscular or intravenous injections, which is safe.

9. Use in elderly patients: Elderly patients, especially those over 60 years old, should use this product with caution.

10. Drug overdose: Drug overdose and acute magnesium poisoning can cause respiratory depression, which can quickly lead to fatal respiratory paralysis. At this time, the drug should be stopped immediately, artificial respiration should be performed, and calcium should be slowly injected for rescue.

oral

1. Cathartic effect: Since it is not absorbed when taken internally, a certain osmotic pressure is formed in the intestine, which keeps a large amount of water in the intestine, expands the volume of intestinal contents, dilates the intestine, stimulates intestinal peristalsis, and allows the contents of the small intestine to quickly enter the large intestine and discharge watery stool.

2. Choleretic effect: Oral administration of high concentration (33%) magnesium sulfate solution, or direct infusion into the duodenum using a catheter, can stimulate the duodenal mucosa, reflexively cause relaxation of the common bile duct sphincter and contraction of the gallbladder, promote gallbladder emptying, and produce a choleretic effect. Clinically used for obstructive jaundice and chronic cholecystitis.

3. For external use: Anti-inflammatory and swelling reduction: Apply 50% magnesium sulfate solution to the affected area for hot compress, which has the effect of anti-inflammatory and swelling reduction.

Intravenous injection

1. Effect on the central nervous system: Increasing the concentration of magnesium ions in the extracellular fluid can inhibit the central nervous system. It is clinically used for anticonvulsants, treatment of preeclampsia and eclampsia, and also for the treatment of premature birth.

2. Effect on the cardiovascular system: Injection of excessive magnesium ions can directly relax the peripheral vascular smooth muscle, dilate the blood vessels, and lower blood pressure. It is clinically used for patients with frequent angina attacks who are not well responded to other treatments, and it is more effective for patients with hypertension. Commonly used for hypertension during pregnancy.

3. Treatment of hypomagnesemia: Normal serum magnesium concentration is between 0.8~05mmol/L, and serum magnesium below 0.75mmol/L is hypomagnesemia.