Magnesium sulfate and procardia

[theamberdawns]

Hello everyone!!! I had a patient with preterm labor. we initially started terb subcut and and procardia po. a second dose of terb was given. still- patient contracted and contracted. so, magnesium was started. the physician also wanted to continue procardia. have any of you done this??? the am nurse freaked out on me and stated that the combo causes pulmonary edema... any thoughts?

[shiccy]

I unfortunately am not an OB RN, but keeping BP down will actually prevent pulmonary edema. Fluid overload can def do that, but I don't know how much IV / mag they're getting. I'd be more concerned with that.

[debbiernbsn]

Procardia, when used with magnesium sulfate infusion, can cause a neuromuscular blockade (paralysis). I have heard it explained simply, that you don't use procardia when the patient is on magsulfate because the procardia is a calcium channel blocker, and what is the antidote to magsulfate toxicity? Yep, calcium gluconate.

P.S. I work on an OB unit and that's how the docs explained it to us. Hope it makes a little sense!

[elanddeenrs]

the only time we do procardia + mag is when we are weaning the pt off mag for the same reason as above poster mentioned.

[littleneoRN]

I unfortunately am not an OB RN, but keeping BP down will actually prevent pulmonary edema. Fluid overload can def do that, but I don't know how much IV / mag they're getting. I'd be more concerned with that.

It doesn't sound like the patient in question had BP issues.