Population pharmacokinetics of magnesium in preeclampsia

Chuan, F.; Charles, Bruce G.; Boyle, Rhonda K.; Rasiah, Rohan

doi:10.1067/mob.2001.116726

Cited by 34 publications

(33 citation statements)

References 17 publications

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“…Magnesium clearance was found to be 48.1 dl/hour, (80.1 ml/minute), comparable to the glomerular filtration rate that might be expected from a cohort of women with pre‐eclampsia and similar to the 50 dl/hour found by Lu et al . and 42.8 dl/hour by Chuan et al . The volume of distribution was 156 dl, 30–50% lower than previously reported.…”

Section: Discussionsupporting

confidence: 86%

“…One‐ and two‐compartment linear elimination models have been used previously to describe the PK of magnesium . The simpler one‐compartment model, with one additional compartment for first‐order intramuscular absorption, was chosen here to describe the data, again because of availability of a single data point per woman.…”

Section: Methodsmentioning

confidence: 99%

“…One-and two-compartment linear elimination models have been used previously to describe the PK of magnesium. 10,11 The simpler one-compartment model, with one additional compartment for first-order intramuscular absorption, was chosen here to describe the data, again because of availability of a single data point per woman. The maximum likelihood population parameter estimates were determined for clearance (CL), volume of distribution (V), intramuscular absorption rate (K A ), intramuscular bioavailability (F) and baseline endogenous steady-state magnesium concentration (BL).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Magnesium sulphate for prevention of eclampsia: are intramuscular and intravenous regimens equivalent? A population pharmacokinetic study

Salinger

Mundle

Regi

et al. 2013

BJOG

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Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Magnesium sulphate for prevention of eclampsia: are intramuscular and intravenous regimens equivalent? A population pharmacokinetic study

Salinger

Mundle

Regi

et al. 2013

BJOG

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“…The model-estimated PK parameters from the current analysis were also generally similar to other literature estimates for 2-compartment models. 15,16 There were several potential limitations to this analysis. First, the presence of endogenous magnesium prior to administration of magnesium sulfate had to be accounted for in the PK model.…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetic Modeling to Evaluate Standard Magnesium Sulfate Treatments and Alternative Dosing Regimens for Women With Preeclampsia

Wenning

Migoya

et al. 2018

The Journal of Clinical Pharma

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Magnesium sulfate is the standard therapy for prevention and treatment of eclampsia. Two standard dosing regimens require either continuous intravenous infusion or frequent, large‐volume intramuscular injections, which may preclude patients from receiving optimal care. This project sought to identify alternative, potentially more convenient, but similarly effective dosing regimens that could be used in restrictive clinical settings. A 2‐compartment population pharmacokinetic (PK) model was developed to characterize serial PK data from 92 pregnant women with preeclampsia who received magnesium sulfate. Body weight and serum creatinine concentration had a significant impact on magnesium PK. The final PK model was used to simulate magnesium concentration profiles for the 2 standard regimens and several simplified alternative dosing regimens. The simulations suggest that intravenous regimens with loading doses of 8 g over 60 minutes followed by 2 g/h for 10 hours and 12 g over 120 minutes followed by 2 g/h for 8 hours (same total dose as the standard intravenous regimen but shorter treatment duration) would result in magnesium concentrations below the toxic range. For the intramuscular regimens, higher maintenance doses given less frequently (4 g intravenously + 10‐g intramuscular loading doses with maintenance doses of 8 g every 6 hours or 10 g every 8 hours for 24 hours) or removal of the intravenous loading dose (eg, 10 g intramusculary every 8 hours for 24 hours) may be reasonable alternatives. In addition, individualized dose adjustments based on body weight and serum creatinine were proposed for the standard regimens.

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“…We speculate that the significant negative correlation between mean SMA BFV and hours after birth in the MgSO4-exposed neonates relates to the vasodilatory effects of MgSO4, described above, and the decreasing serum levels of magnesium. Magnesium has a half-life of 5.2 h in preeclamptic women [38] and 1 40 h in neonates exposed to antenatal MgSO 4 [12] . While the relationship between SMA BFV and the development of bowel pathologies in neonates is unclear, low SMA BFV is reportedly associated with the development of NEC [27,28] , intestinal dysmotility and feeding intolerance [24][25][26] .…”

Section: Discussionmentioning

confidence: 99%

Effects of Maternal Magnesium Sulfate Administration on Intestinal Blood Flow Velocity in Preterm Neonates

et al. 2011

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Background: Antenatal MgSO₄ administration is used extensively as a tocolytic agent and to treat preeclampsia. Various effects on the fetus and newborn have been reported, and MgSO₄ has well-documented vasoactive effects. Objective: To determine if antenatal MgSO₄ administration affects intestinal blood flow velocity in newborn preterm infants. Methods: Peak, mean and end-diastolic velocities in the superior mesenteric artery were measured on day 1 of life. Maternal medical records were reviewed to identify infants whose mothers had been administered MgSO₄ for preterm labor or preeclampsia within 24 h of delivery. Result: Fifty-six infants were studied: 27 were exposed and 29 were not exposed to antenatal MgSO₄. Mean birth weight (1,371 ± 349 and 1,401 ± 469 g, respectively), gestational age (29.7 ± 2.0 and 30.0 ± 2.9 weeks, respectively) and infant hemodynamic and clinical variables (other than clinical indication for antenatal MgSO₄ administration) were similar between groups. There were no significant differences between the exposed and unexposed groups in intestinal blood flow velocities. For the exposed group, however, there was a significant negative correlation between mean velocity and the number of hours from birth to the time superior mesenteric artery blood flow velocity measurements were made (p = 0.002); there was no correlation for the unexposed group (p = 0.852). Conclusion: Group mean values indicate that antenatal exposure to MgSO₄ does not significantly affect intestinal blood flow velocity in newborn preterm infants. However, the significant negative relationship between mean blood flow velocity and time from birth to blood flow velocity measurement in exposed infants suggests that there may be measurable effects of MgSO₄ exposure within the hours immediately after birth. Trials that prospectively evaluate the development of intestinal blood flow velocities are needed to further clarify potential effects of antenatal MgSO₄ on the gastrointestinal tract of preterm infants.

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Population pharmacokinetics of magnesium in preeclampsia

Cited by 34 publications

References 17 publications

Magnesium sulphate for prevention of eclampsia: are intramuscular and intravenous regimens equivalent? A population pharmacokinetic study

Magnesium sulphate for prevention of eclampsia: are intramuscular and intravenous regimens equivalent? A population pharmacokinetic study

Population Pharmacokinetic Modeling to Evaluate Standard Magnesium Sulfate Treatments and Alternative Dosing Regimens for Women With Preeclampsia

Effects of Maternal Magnesium Sulfate Administration on Intestinal Blood Flow Velocity in Preterm Neonates

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