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Re: Terbutaline, MgSO4From: Richard Lowensohn (lowensoh@ohsu.edu)Tue Dec 30 18:19:00 1997
Dr. Sanchez-Ramos - 1) Since the number of trials on efficacy is small, it makes little sense to dismiss the possibility that it might work. Safety was (heretofor) based on the ample years of experience in pre-eclampsia. The University of Chicago study is the first to suggest that there may be other concerns in premature fetuses. 2) The pharmacologic principle is that the only way to use a drug is to use it to effect and/or a specific target blood level. In this case, the data show that it takes a lot in to get to a good blood level, since the kidneys do such a good job of taking it back out. Most of our patients maintain stable levels (long-term) on 2 or even 2 1/2 grams/hour, so it makes sense that it would take more to raise it.
-- Richard Lowensohn Oregon Health Sciences University >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> >Richard: > >First of all, the number of randomized trials assessing the efficacy and >safety of magnesium sulfate as a tocolytic is small (hardly a "plethora" >(see recent meta-analysis in ObGyn Survey) >The way you use terbutaline and your protocol for MgSO4......"3 grams >for the first few hours" hardly qualify as "basic pharmacologic >principles" > >LSanchez-Ramos MD
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