Thursday, May 3, 2012

Pharmacology II

A 30 year old G1P0 at 38 weeks is undergoing active labor. Her blood pressure is 145/92 and she has 4+ protein in her urine. She is 5 cm dilated. Fetal heart tones are reassuring. The resident writes her for magnesium 6g IV load followed by an infusion. However, just as the nurse is about to give it, you stop her and ask the patient: do you ever have fluctuating muscle fatigue, especially after exercise or later in the day? You ask: do you ever see double or get jaw tiredness when eating a steak?

Challenge: What are you asking about and why?

Image shown under GNU Free Documentation License.


Anonymous said...

myasthenia gravis, will affect neuromuscular transmission and increase muscle weakness


Myasthenia Gravis, Magnesium inhibits release of Acetylcholine.

Craig Chen said...

yes! nice job :)
Pharmacology II

Magnesium sulfate is contraindicated in women with myasthenia gravis because it can precipitate a severe myasthenic crisis. The side effects of magnesium include flushing, warmth, nausea, vomiting, muscle weakness, visual disturbances, and palpitations. Magnesium toxicity is associated with loss of deep tendon reflexes, respiratory paralysis, and cardiac arrest.

Sources: UpToDate, Wikipedia.