Diuretics, Ipecac, and Laxatives

Rangan, Cyrus

doi:10.1002/9781118105955.ch12

Cited by 4 publications

(1 citation statement)

References 196 publications

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“…26 MgSO 4 can cause significant fluid and electrolyte loss, the effects of which may be additive to those of diuretics. 27 Metabolic imbalances – including the depletion of sodium, potassium, magnesium, and zinc – may occur and have been associated with heart failure and cardiac arrhythmias. 28,29 In this study, it was found that the concomitant administration of MgSO 4 and furosemide was associated with an increased risk of cardiopulmonary adverse events, which may have occurred as a consequence of profound fluid loss and electrolyte imbalances.…”

Section: Commentmentioning

confidence: 99%

Intrapartum Magnesium Sulfate and the Potential for Cardiopulmonary Drug–Drug Interactions

Campbell

Stockmann

Balch

et al. 2014

Therapeutic Drug Monitoring

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Objective This study sought to determine the frequency of possible cardiopulmonary drug-drug interactions among pregnant women who received intrapartum magnesium sulfate (MgSO4). Methods Pregnant women admitted to an Intermountain Healthcare facility between January 2009 and October 2011 were studied if they received one or more doses of MgSO4. Concomitant medications were electronically queried from an electronic health records system. Adverse events were identified using administrative discharge codes. The frequency of cardiopulmonary drug-drug interactions was compared among women who did, and did not, receive aminoglycoside antibiotics, antacids / laxatives, calcium channel blockers, corticosteroids, diuretics, neuromuscular blocking agents, and vitamin D analogs, all of which are contraindicated for patients receiving MgSO4. Results Overall, 683 women received intrapartum MgSO4 during the study period. A total of 219 MgSO4 potentially interacting drugs were identified among 155 (23%) unique patients. The most commonly identified potentially interacting agents included calcium channel blockers (26%), diuretics (25%), and antacids / laxatives (19%). Longer hospital stays were significantly associated with increasing numbers of MgSO4 interacting drugs (P<0.001). Three of 53 (6%) women who received furosemide experienced a cardiac arrest, compared to 0 of 618 (0%) women who did not receive furosemide (Fisher’s Exact Test P<0.001). Conclusion Intrapartum administration of drugs that interact with MgSO4 is common and associated with prolonged hospital stays and potentially cardiopulmonary drug-drug interactions. Caution is warranted when prescribing MgSO4 in combination with known interacting medications.

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