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

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