QuestionSBA
QuestionChoice
Antiepileptics including phenytoin should not be given, likewise for tocolytics, as this woman is 38 weeks pregnant and delivery would help with her eclampsia
34478
d
Terbutaline 5 micrograms/minute for 20 minutes
QuestionChoice
This patient has a history of headache, abdominal pain and presented with generalized tonic clonic seizure. In addition, her blood pressure at 25 weeks was normal but is currently significantly elevated. Her signs and symptoms in combination with her investigation results of haemolytic anaemia, elevated liver transaminases and lower platelet count is suggestive of eclampsia with HELLP syndrome. Magnesium sulphate should be given to treat eclampsia alongside antihypertensive medications such as labetalol
34475
a
Magnesium sulphate IV 4g over 5-15minutes, labetalol hydrochloride 20mg/hour IV
QuestionChoice
Magnesium sulphate should be given to treat eclampsia alongside antihypertensive medications such as labetalol. Dexamethasone is not necessary as this woman is currently 38 weeks pregnant
34476
b
Magnesium sulphate IV 4g over 5-15minutes, labetalol hydrochloride 20mg/hour IV,
dexamethasone 8mg IV
QuestionChoice
Antiepileptics including phenytoin should not be given, likewise for tocolytics, as this woman is 38 weeks pregnant and delivery would help with her eclampsia
34479
e
Atosiban 6.75mg IV over 1 minute
QuestionChoice
Antiepileptics including phenytoin should not be given, likewise for tocolytics, as this woman is 38 weeks pregnant and delivery would help with her eclampsia
34477
c
Two doses of Lorazepam 6mg IV followed by phenytoin 1.2g IV
QuestionComment
As she has HELLP syndrome, shouldn't the first line treatment be to deliver i.e. give IV dexamethasone + Magnesium sulfate and labetalol?
8072
QuestionComment
You wouldn't give dexmethasone because this is not pre-term (the pregnancy is >37 weeks). in addition the dexamethasone is usually given IM
16735
User
subscriber
Recessive Myotonia
User
subscriber
Amnesia Retrograde
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2838
Eclampsia treatment
Topic
76
Obstetrics and Gynaecology
6906
Case Presentation:


A 38-week pregnant lady is admitted to the Emergency Department with generalized tonic-clonic seizure. Prior to the onset of the seizure, her husband mentioned she had been complaining of headache and abdominal pain. PMH Gestational diabetes. DH Metformin 1g BD PO. Weight 60kg


 **On Examination**
BP 205/100 mmHg (on admission) (<140/90mmHg), HR 92/min, RR 22
BP 92/50 mmHg (at 25 weeks)


 **Investigations**
Urine dipstick ++ protein

||||
|--------------|:-------:|---------------|
|Haemoglobin|110   g/L|(M) 130 - 170, (F) 115 - 155|
|White Cell Count|8x10<sup>9</sup>/L|3.0 - 10.0|
|Platelets|80x10<sup>9</sup>/L|150 - 400|
|Bilirubin|1.5 µmol/L|< 17|
|Aspartate Aminotransferase (AST)|80IU/L|10 - 40|
|Alanine Aminotransferase (ALT)|140 IU/L|10 - 50|
|Creatinine|123 µmol/L|60 - 120|
|Creatinine|0.66 mmol/L|0.19 - 0.36|


Question:
Select the most appropriate decision option with regard to the treatment of her eclampsia based on these data.
a