Interrupts the entero-hepatic cycle with multiple dose.Īlbuterol inhaler, insulin & glucose, NaHCO 3, kayexalateĬompetitive inhibition of muscarinic receptors. Non-specific poisons except cyanide, iron, lithium, caustics and alcohol.Ībsorption of drug in the gastric and intestinal tracts. Restores depleted glutathione stores and protects against renal and hepatic failure. All rights reserved.ADVERTISEMENTS Table of Antidotes Antidote © 2020 by the American College of Obstetricians and Gynecologists. The use of alternative anticonvulsant medications in preeclampsia, which may be less efficacious, must be reserved for true contraindications to magnesium sulfate. Five cases did not document any contraindication.
The most commonly documented contraindication was pulmonary edema (n=14) which was confirmed by imaging (either ultrasound or chest x-ray) in less than half of cases other reasons included changes in laboratory data (n=11 increasing serum creatinine, serum magnesium >7 mg/dL), development of additional signs/symptoms (n=11 hypotension, headache, vision changes, decreased urine output) and patient refusal (n=3). Most of the levetiracetam group (79.5%) initially received magnesium. RESULTS:Ī total of 1,370 patients were included 3.2% (n=44) received levetiracetam for seizure prophylaxis. Patients were excluded if they had a pre-existing seizure disorders or incomplete medical records.
Demographics, clinical characteristics and contraindications to magnesium sulfate, if present, were evaluated. IRB approved, retrospective cohort study of women with a diagnosis of preeclampsia at 34 weeks of gestation or greater who received seizure prophylaxis at a tertiary university hospital from 2014-2017. Our objective was to determine how frequently alternative anticonvulsant medications are administered for seizure prophylaxis in severe preeclampsia and to identify the documented indications in such cases.
Levetiracetam, an alternative antiepileptic drug considered safe in pregnancy, has been suggested in such cases though its efficacy remains uncertain. Absolute or relative contraindications to this medication include myasthenia gravis, severe renal failure, cardiac ischemia, heart block and pulmonary edema.
Intravenous magnesium sulfate is considered first-line seizure prophylaxis for preeclampsia, reducing the risk of eclampsia by half.
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