Monitoring &management of magnesium toxicity Renal Excretion Pre eclamptics prone to renal failure Mgso4 crosses placenta and there can be evidence of decreased beat to beat variability in feral heart rate,neonatal depression can also occur Magnesium level must be monitored frequently either clinically (patellar reflexes) or by checking serum levels 6---8 Hrly Therapeutic range 4----6 mEq/L Normal levels ; 1.5 --2 mEq/L Monitoring knee jerk & mg levels if possible, respiration, urine out put (>100 ml in 4 hrs) Toxicity 6---8mEq/L. Nausea , vomiting, diplopopia , somnolence, and decreased myometeial contractility .
5---10mEq/L. Increased P Q interval, wide QRS complex >10 mEq/L loss of deep tendon reflexes 15 mEq/L SA & AV blocks Respiratory paralysis 25mEq/L Cardiac arrest Treatment: Stop mgso4 , support ventilation, calcium glauconite 1 G (10%) over 10 minutes How to avoid magnesium…
