THE CONTEXT
The passage continues magnesium sulfate treatment for eclampsia and describes recurrent seizure treatment, toxicity findings, and toxicity management.
Treatment duration and recurrent seizures
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Continue magnesium sulfate for 24 hours after the last seizure or delivery, whichever is later.
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For recurrent fits, give a further 2 g intravenous bolus over 5 minutes in the described regimens.
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If seizures occur despite magnesium therapy, the passage specifies midazolam 1–2 mg intravenously, which may be repeated after 5–10 minutes.
Findings monitored for toxicity
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Monitor for loss of deep tendon reflexes, respiratory rate below 16 per minute, and urine output below 30 mL/hour.
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Other listed findings include chest pain, heart block, and pulmonary edema.
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The passage also lists respiratory depression, altered cardiac conduction, and cardiac arrest among magnesium toxicity effects.
Management of magnesium toxicity
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Stop magnesium therapy and estimate serum magnesium and creatinine levels.
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The stated treatment includes calcium gluconate 10 mL of a 10% solution given slowly intravenously, along with fluid loading and forced diuresis.
Other anticonvulsant regimens listed
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Other listed regimens are a lytic cocktail containing chlorpromazine, promethazine, and pethidine; diazepam; and phenytoin.