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In pharmacokinetics, a loading dose is an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose. [ 1 ] A loading dose is most useful for drugs that are eliminated from the body relatively slowly, i.e. have a long systemic half-life .
Commonly used tocolytic medications include β 2 agonists, calcium channel blockers, NSAIDs, and magnesium sulfate. These can assist in delaying preterm delivery by suppressing uterine muscle contractions and their use is intended to reduce fetal morbidity and mortality associated with preterm birth. [ 2 ]
The use of intravenous or intramuscular magnesium sulfate improves outcomes in those with severe pre-eclampsia and eclampsia and is generally safe. [ 4 ] [ 13 ] Treatment options include blood pressure medications such as hydralazine and emergency delivery of the baby either vaginally or by cesarean section .
The definitive treatment for pre-eclampsia is the delivery of the baby and placenta, but danger to the mother persists after delivery, and full recovery can take days or weeks. [13] The timing of delivery should balance the desire for optimal outcomes for the baby while reducing risks for the mother. [15]
As a bronchodilator after beta-agonist and anticholinergic agents have been tried, e.g. in severe exacerbations of asthma. [4]Obstetrics: Magnesium sulfate is used to prevent seizures in women with preeclampsia and eclampsia, and is also used for fetal neuroprotection in preterm deliveries, but has been shown to be an ineffective tocolytic agent.
Magnesium sulfate is effective in decreasing the risk that pre-eclampsia progresses to eclampsia. [24] Intravenous magnesium sulfate is used to prevent and treat seizures of eclampsia. It reduces the systolic blood pressure but does not alter the diastolic blood pressure, so the blood perfusion to the fetus is not compromised.
[citation needed] Magnesium sulfate has been studied in the treatment of asthma, [17] preeclampsia and eclampsia. [18] Magnesium sulfate is usually the main component of the concentrated salt solution used in isolation tanks to increase its specific gravity to approximately 1.25–1.26. This high density allows an individual to float ...
Chronic kidney disease, excretion of magnesium becomes impaired when creatinine clearance falls below 30 ml/min. However, hypermagnesemia is not a prominent feature of chronic kidney disease unless magnesium intake is increased. [citation needed] Magnesium toxicity from emergency pre-eclampsia treatment during labor and delivery. [citation needed]
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