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Pre-eclampsia with Severe HTN Refractory to Labetalol? - DQI

Updated: Jan 15


 


 

#DrugQueryInbox with Mark


@zakkurii, Instagram "Preg pt in ED w/ preeclampsia, BP 236/157. Pt on max labetalol w min response. ED called for your recommendation. What else would you recommend?"


With on the fly consults like this, go through your options you KNOW you have to give. Per ACOG Guidelines, patient NEEDS to have received MgSO4 IV bolus 4-6 g , followed by 2 g/hr. This mom is on the verge of HELLP Syndrome and/or progression into eclampsia so forsure ensure she got 6 grams. You've got IV hydralazine 10 - 20 mg IV q 5 - 15 minutes (depending on comfort/practice) and immediate release oral nifedipine 10 mg po q 15 minutes. Of these two agents, oral nifedipine provides more predictable kinetics, but thats if the mother tolerate orals.


Let me know your questions in the comments or shoot me a DM, and I hope you learned something new.


 

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Not medical advice. Educational purposes only. No relationships to report.


 

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