Bela
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Ok guys. We know that definite treatment is delivery of the baby. But, what is the drug of choice in these pts?
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| mjl1717
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MgSO4,Hydralazine,aspirin
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| Alina T
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1. decrease BP by using hydralazine, labetalol or dyazoxide (i.v.), then continue with nifedipine or alfametildopa (p.o.)
NO DIURETICS!! NO ACE inh.!!
2. Aspirin in low doses seems to decrease the frequency of severe eclampsia.
3. one q on MgSO4. I know that it is given usually in preeclampsia but i don't know how it works. does it have an effect in lowering the BP, or just to prevent the neurologic complications?
Also, the q was "what's THE DOC in preeclampsia". is there ONE DOC??
thanks for ur replies. 
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| Idiopathic
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Strong association between decreased CSF magnesium and increased seizure activity. MgSO4 is given prophylactically in pre-eclamptic cases, even when delivery is imminent. That would be my only DOC.
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| Alina T
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thank you, Idiopathic, what u answered was what I knew also, but the fact is that TODAY (haa!, how about that!?) , my Emergency med professor told me that MgSO4 is recently used in the protocols to treat arrhythmias, usually before cardioversion (it increases heart electrical sensitivity, or smth like this), plus, it seems to have a hypotensive effect also. he said the mechanism isn't very well known, and there are current research studies on this.
......thought maybe someone heard more details on this.....i dont think it is vital for us, step1-guys, to know this stuff, ....... but i'm just curious......
:wink:
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| Idiopathic
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Yeah, what we need to know is just its anti-seizure activity.
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| Bela
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Yup, I agree w/Idiopathic. The only thing I had in mind was MgSO4.
Pt. has pre-eclampsia :arrow: try not to allow her to get to eclampsia.
Aspirin Alina is known to have a rather insignificant effect in pre-eclampsic pts and by the way, if you get to eclampsia, I think u're in pretty big trouble. Aspirin would not help AT ALL and immediate DELIVERY would be the main course a physician would take.
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| Bela
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oh, about the cardio effects of MgSO4....it is used to treat Torsade de Pointes and digitalis toxicity.
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| Alina T
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thanx guys!!
just found out that its hypotensive effect seems to appear only in combination with Ca channel blockers, by amplifying their action. :?
haaaa.......somebody shoot me, cant get over this????? :lol: :lol:
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| Bela
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"Alina T" wrote:
haaaa.......somebody shoot me,
No wayyyyyyy, exhange my medical career with a prison career??? 
Don't worry girl. We all have our weak points and this site is to aid each other in strengthening our knowledge so that one day we really know our stuff cold. 
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