In adult magnesium sulfate management of eclampsia, what is the maintenance infusion rate to prevent continued seizures?

• A. 10 mg/min IV/IO drip to prevent continued seizures.
• B. 5 mg/min IV/IO drip
• C. 20 mg/min IV/IO drip
• D. None; maintenance not used

Answer: (A)

Maintaining therapeutic magnesium levels after the initial loading dose is essential to prevent recurrent seizures in eclampsia. The maintenance infusion keeps a steady supply of magnesium so the brain remains protected from seizure activity, rather than letting levels drop and allowing breakthrough seizures.

In this protocol, the maintenance rate is 10 mg per minute via IV/IO drip. This continuous infusion aims to sustain seizure prophylaxis while monitoring for toxicity. Signs of magnesium toxicity to watch for include diminished or absent deep tendon reflexes, respiratory depression, decreased consciousness, and hypotension; if toxicity occurs, stop the infusion and have calcium gluconate ready as the antidote.