Most effective & safe drug to control fits in eclampsia is:
Ans. b (Magnesium sulphate). (Ref Williams Obstetrics 22nd/ Ch. 34; Obstetrics by Dutta, 3rd/ 244)MAGNESIUM SULFATE# Magnesium sulfate is the treatment of choice for the prevention and treatment of eclamptic seizures.# In more severe cases of preeclampsia, as well as eclampsia, magnesium sulfate administered parenterally is an effective anticonvulsant agent without producing central nervous system depression in either the mother or the infant.# It may be given: intravenously by continuous infusion or intramuscularly by intermittent injection.# The dosage schedule for severe preeclampsia is the same as for eclampsia.# Magnesium sulfate is not given to treat hypertension.# Magnesium most likely exerts a specific anticonvulsant action on the cerebral cortex.Regimens for the Administration of Magnesium Sulfate for Seizure Prophylaxis in Labor with Preeclampsia.IntramuscularIntravenous10 g (5 g IM deep in each buttock)6-g bolus over 15 min1-3 g/h by continuous infusion pump5 g IM deep q4h, alternating sidesMay be mixed in 100 mL crystalloid; if given by intravenous push, make up as 20% solution; push at maximum rate of 1 g/min 40-g MgSO4 in 1000 mL Ringer's lactate; run at 25-75 mL/h (1-3 g/h)# Typically, the mother stops convulsing after the initial administration of magnesium sulfate and, within an hour or two, regains consciousness sufficiently to be oriented as to place and time.# Maintenance magnesium sulfate therapy for eclampsia is continued for 24 hours after delivery.# For eclampsia that develops postpartum, magnesium sulfate is administered for 24 hours after the onset of convulsions.# Magnesium sulphate practically always arrests eclamptic convulsions and prevents their recurrence.# The initial intravenous infusion of 4 to 6 g is used to establish a prompt therapeutic level that is maintained by the nearly simultaneous intramuscular injection of 10 g of the compound, followed by 5 g intramuscularly every 4 hours, or by continuous infusion at 2 to 3 g per hour.# Parenterally administered magnesium is cleared almost totally by renal excretion, and magnesium intoxication is avoided by ensuring that:- urine output is adequate,- the patellar or biceps reflex is present, and- there is no respiratory depression. EffectPlasma magnesium levels1Eclamptic convulsions are almost always prevented by levels maintained at:4 to 7 mEq/L(4.8 to 8.4 mg/dL, or 2.0 to 3.5 mmol/L).2Patellar reflexes disappear at:10 mEq/L (about 12 mg/dL)3Respiratory depression develops at:>10 mEq/L4Respiratory paralysis and arrest follows at:>12 mEq/L
Phenytoin
Magnesium sulphate
Diazepam
None
Miscellaneous (Gynae)