Obstetric Pharmacology

Magnesium Sulfate
Actions

Not clearly understood Seems to decrease release of acetylcholine at neuromuscular junction Depresses central nervous system Causes mild vasodilation
Decreases blood pressure Improves placental blood flow

Magnesium Sulfate
Indications

Anticonvulsant effects in:

Pre-eclampsia Eclampsia

Magnesium Sulfate
Contraindications

Renal disease Cardiac failure AV conduction defects Myasthenia gravis

Magnesium Sulfate
Adverse

effects

Muscle weakness Respiratory depression Hypotension Slowed cardiac conduction/AV blocks

Magnesium Sulfate
Antidote

to toxic effects

Calcium

Magnesium Sulfate
Dose

Initial: 4 to 8 gm IV over 20 minutes Maintenance: 1 to 2 gm/hr

Pitocin
Action

Synthetic oxytocin Stimulates uterine smooth muscle contraction

Pitocin
Indication

Control of postpartum hemorrhage

Pitocin
Contraindication

Do not administer until after baby, placenta fully delivered May cause trapping of placenta or second twin in uterus

Pitocin
Adverse

effects

Nausea, vomiting Cardiac arrhythmias Fluid retention with water intoxication Transient vasodilation, reflex tachycardia

Pitocin
Dose

10 to 40 units in 1 L of crystalloid Infuse to:

Sustain uterine contraction Control hemorrhage