Study note
Obstetrics & GynecologyHypertensive Disorders in Pregnancy

Magnesium sulfate: therapeutic level, toxicity and contraindications

THE CONTEXT
During magnesium sulfate treatment for eclampsia, serum concentration, renal function and signs of toxicity guide selected monitoring.

Therapeutic level and monitoring

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The therapeutic serum magnesium level is 4–7 mEq/L.
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Serum magnesium may be monitored in selected cases, including renal insufficiency or absent deep tendon reflexes.

Toxicity and antidote

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Magnesium toxicity is uncommon in women with adequate renal function and correlates with the serum magnesium concentration.
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Calcium gluconate is the antidote for severe cardiac toxicity related to hypermagnesemia.

Contraindications

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Listed contraindications to magnesium sulfate are myasthenia gravis, moderate to severe renal failure, cardiac ischemia, heart block and myocarditis.
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