Which is the drug of choice for controlling eclamptic fits

Appeared in: Hariyana-CHO-2021

Explanation

Magnesium sulphate (MgSO4) is the first-line anticonvulsant for treating and preventing eclamptic seizures due to its proven efficacy and safety profile.
It acts as a central nervous system depressant by reducing the presynaptic release of the neurotransmitter glutamate and blocking NMDA receptors, thereby raising the seizure threshold.
Large-scale clinical trials, such as the Magpie Trial, have demonstrated that MgSO4 is significantly more effective than placebo, phenytoin, and diazepam in reducing the risk of eclampsia and recurrent seizures.

Option A: Sodium Bicarbonate is an alkalinizing agent used to correct severe metabolic acidosis.
Option B: Calcium Gluconate is the specific antidote for magnesium sulphate toxicity.
Option D: Oxytocin is a hormone that stimulates uterine contractions.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological management of eclamptic seizures helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The nurse's primary role during MgSO4 administration is vigilant monitoring for signs of toxicity to ensure patient safety. This is a critical nursing responsibility.
Key monitoring includes hourly checks of respiratory rate, deep tendon reflexes (patellar reflex), and urine output. Any deviation from normal must be reported immediately.
The antidote, 10% Calcium Gluconate, must be kept at the bedside for immediate administration in case of toxicity.

How to Approach the Question

First, identify the core clinical problem presented in the question: controlling 'eclamptic fits,' which are tonic-clonic seizures occurring in a pregnant woman with preeclampsia.
Next, recall the first-line pharmacological agent recommended for this specific obstetric emergency.
Evaluate each option based on its primary mechanism of action and clinical use.
Eliminate Injection Sodium Bicarbonate, as it is used for correcting acidosis, not seizures.
Eliminate Injection Oxytocin, as it is used for uterine contractions, not seizure control.
Differentiate between Injection Magnesium Sulphate and Injection Calcium Gluconate. Recognize that while both are used in the context of eclampsia management, MgSO4 is the primary treatment for the seizures, and Calcium Gluconate is the antidote for MgSO4 toxicity.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 33-54

Practise the full Hariyana-CHO-2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.