What is the correct Magnesium Sulfate dose/delivery for eclampsia?

• A. Magnesium Sulfate 2g IV push over 2 minutes
• B. Calcium gluconate 1 g IV
• C. Magnesium Sulfate 6g in 500 mL NS over 1 hour
• D. Magnesium Sulfate 4g in 100 mL NS over 10 minutes

Answer: (C)

Magnesium sulfate is given in eclampsia to rapidly raise magnesium levels and help prevent seizures, using a controlled IV loading dose followed by a maintenance infusion. The option of 6 g in 500 mL of normal saline over one hour delivers a loading dose in a single, monitored infusion, which helps achieve therapeutic levels quickly while reducing the risk of toxicity from a very rapid bolus. This approach aligns with common practice of delivering a loading dose in a predictable manner and then continuing with maintenance infusion to keep levels therapeutic.

The other choices are less appropriate: giving a small IV push (2 g) is too rapid and may cause spikes in magnesium that increase toxicity risk; using calcium gluconate is the antidote for magnesium toxicity, not a treatment regimen for eclampsia; and delivering 4 g in 100 mL over 10 minutes represents a faster, smaller-dose bolus rather than the controlled loading-and-maintenance plan used to maintain stable magnesium levels. Monitoring for signs of toxicity, such as diminished reflexes and slowed respiration, is essential with any magnesium sulfate regimen.