Population Pharmacokinetics of Magnesium Sulfate in Preeclampsia and Associated Factors

Abstract

Background and Objective The pharmacokinetic basis of magnesium sulphate (MgSO 4) dosing regimens for preeclampsia (PE) prophylaxis and treatment is not clearly established. The aim of study is to develop a population pharmacokinetic (PK) model of MgSO 4 in PE, and to determine key covariates having an effect in MgSO 4 pharmacokinetics in preeclampsia (PE) and to determine key covariates having an effect in MgSO 4 PK. Methods A prospective cohort study was conducted from June 2016 to February 2018 in patients with PE administered MgSO 4 as a 4-g bolus followed by continuous infusion at a rate of 1 g/h. Serum magnesium concentrations were obtained before treatment administration and 2, 6, 12, and 18 h after the initial dose. The software Monolix was used to estimate population PK parameters of MgSO 4 [clearance (CL), volume of distribution (V), half-life] and to develop a PK model with baseline patient demographic, clinical, and laboratory covariates. Results The study population consisted of 109 patients. The PK profile of MgSO 4 was adequately described by a one-compartment PK model. The model estimate of the population CL was 1.38 L/h; for V, it was 13.3 L; and the baseline magnesium concentration was 0.77 mmol/L (1.87 mg/dL). The baseline body weight and serum creatinine statistically influenced MgSO 4 CL and V, respectively. The model was parameterized as CL and V. Conclusion The PK of MgSO 4 in pregnant women with PE is significantly affected by creatinine and body weight. Pregnant women with PE and higher body weight have a higher V and, consequently, a lower elimination rate of MgSO 4. Pregnant women with PE and a higher serum creatinine value show lower CL and, therefore, lower MgSO 4 elimination rate.

Effect of Educational Program of Eclampsia Management on Knowledge of Maternity Nurses at Mosul Teaching Hospitals

“…The latest guidelines are for the administration of magnesium sulfate in patients with serious preeclampsia for seizure prophylaxis. Although magnesium sulfate is not threat-free, the key benefit of magnesium is its long safety record for mothers and children while avoiding maternal seizures [12] [13].…”

“…The maximum score obtainable was (15) while the minimum score was (0). Scores from (0-5) show "poor knowledge," scores from (6-10) show "good knowledge" and scores from (11)(12)(13)(14)(15) show "excellent knowledge".…”

Compatibility and stability of an admixture of multiple anaesthetic drugs for opioid‐free anaesthesia

“…There are, however, no available pharmacokinetic studies available that report a minimum effective analgesic concentration for magnesium. Magnesium sulphate pharmacokinetic models are only available for pregnant women, specifically aimed at those with pre‐eclampsia [29, 30]. Both analyses found that renal dysfunction (based on serum creatinine levels) affected magnesium sulphate pharmacokinetics and it should, therefore, be used with caution in patients with abnormal renal function.…”

Effect of Mg-Gluconate on the Osmotic Fragility of Red Blood Cells, Lipid Peroxidation, and Ca2+-ATPase (PMCA) Activity of Placental Homogenates and Red Blood Cell Ghosts From Salt-Loaded Pregnant Rats

“…The current knowledge on the role of magnesium treatment in PE with severe features has focused on the study of magnesium sulfate (MgSO 4 ; Amaral et al, 2017;Chiarello et al, 2018). MgSO 4 is an important pharmacological tool used to treat PE with severe features because it can prevent the recurrent seizures of eclampsia and tocolysis in preterm labor (Sibai, 2005;Smith et al, 2013;Da Costa et al, 2020). This salt is mainly administered intravenously because the oral route is well known to produce gastrointestinal effects and it is poorly absorbed in the gut (Lu and Nightingale, 2000).…”