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Nursing Considerations:
- Assess history of allergy to the drug and other contraindications
- Reserve IV use in eclampsia for immediate life- threatening situations
- Monitor magnesium levels during parenteral therapy
- Monitor knee-jerk reflex before repeated parenteral administration, if
happens, do not administer because respiratory failure may occur
- Do not give orally with abdominal pain, N/V
- Monitor urine output
Adverse effects
CNS: Transient, mild drowsiness (initially); sedation, depression, lethargy,
apathy, fatigue, light-headedness, disorientation, restlessness, confusion,
crying, delirium, headache, slurred speech, dysarthria, stupor, rigidity,
tremor, dystonia, vertigo, euphoria, nervousness, difficulty in concentration,
vivid dreams, psychomotor retardation, extrapyramidal symptoms; mild
paradoxical excitatory reactions (during first 2 wk of treatment), visual and
auditory disturbances, diplopia, nystagmus, depressed hearing, nasal
congestion
CV: Bradycardia, tachycardia, CV collapse, hypertension, hypotension,
palpitations, edema
Dermatologic: Urticaria, pruritus, skin rash, dermatitis
GI: Constipation, diarrhea, dry mouth, salivation, nausea, anorexia, vomiting,
difficulty in swallowing, gastric disorders, elevations of blood enzymes: LDH,
alkaline phosphatase, AST, ALT, hepatic dysfunction, jaundice
GU: Incontinence, urinary retention, changes in libido, menstrual
irregularities
Hematologic: Decreased Hct, blood dyscrasias
Other: Phlebitis and thrombosis at IV injection sites, hiccups, fever,
diaphoresis, paresthesias, muscular disturbances, gynecomastia; pain,
burning, and redness after IM injection
Dependence: Drug dependence with withdrawal syndrome when drug is
discontinued (more common with abrupt discontinuation of higher dosage
used for longer than 4 mo)
Nursing considerations
Contraindications:
- Contraindicated in pediatric patients for monitored anesthesia care
(MAC) sedation or for sedation in intensive care; epileptics; use
cautiously in lactation
Adverse Effects:
CV: Arterial hypotension; decreased systemic vascular resistance,
myocardial blood flow, and oxygen consumption, palpitations, tachycardia
Respiratory: apnea, hyperventilation, bradypnea, dyspnea, wheezing,
swelling of throat
CNS: increased ICP, lethargy, drowsiness, euphoria, hallucinations, blurred
vision, anxiety, tension, seizure, lightheadedness, fainting
DERM: skin rash, flushing, urticaria
Nursing Considerations:
- Assess history of allergy to the components of the drug.
- Use safety precautions after administration.
- Advise patient that mental alertness, coordination, and physical
dexterity may be impaired for some time after administration.
- For IV, do not mix with other therapeutic agents prior to
administration. Avoid mixing blood or plasma in same IV catheter.
- Minimize pain associated with administration by infusing into larger
veins.
- Should be administered only by personnel who are trained in
administration of general anesthesia and familiar with drug.
- Shake well before use. Do not use if there is evidence of separation of
phases of emulsion.