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Obstetric Pharmacology

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

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Obstetric Pharmacology

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  1. Obstetric Pharmacology

  2. 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

  3. Magnesium Sulfate • Indications • Anticonvulsant effects in: • Pre-eclampsia • Eclampsia

  4. Magnesium Sulfate • Contraindications • Renal disease • Cardiac failure • AV conduction defects • Myasthenia gravis

  5. Magnesium Sulfate • Adverse effects • Muscle weakness • Respiratory depression • Hypotension • Slowed cardiac conduction/AV blocks

  6. Magnesium Sulfate • Antidote to toxic effects • Calcium

  7. Magnesium Sulfate • Dose • Initial: 4 to 8 gm IV over 20 minutes • Maintenance: 1 to 2 gm/hr

  8. Pitocin • Action • Synthetic oxytocin • Stimulates uterine smooth muscle contraction

  9. Pitocin • Indication • Control of postpartum hemorrhage

  10. Pitocin • Contraindication • Do not administer until after baby, placenta fully delivered • May cause trapping of placenta or second twin in uterus

  11. Pitocin • Adverse effects • Nausea, vomiting • Cardiac arrhythmias • Fluid retention with water intoxication • Transient vasodilation, reflex tachycardia

  12. Pitocin • Dose • 10 to 40 units in 1 L of crystalloid • Infuse to: • Sustain uterine contraction • Control hemorrhage

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