View source for Obstetric agents (magnesium, steroids, tocolytics, fertility)

{{Drugbox
| name = Obstetric agents (magnesium, steroids, tocolytics, fertility)
| therapeutic = Obstetric agents
| pharmacologic = Electrolyte and anticonvulsant (magnesium), corticosteroids, beta agonist tocolytic, ovulation stimulant
| onset = Magnesium IV onset rapid; betamethasone effect over 24 to 48 hours.
| halflife = Magnesium therapeutic range for preeclampsia about 4 to 7 mEq/L.
| routes = PO (oral), IV, IM
| highalert = <span style="color:#b00020;">'''Yes'''</span> (magnesium sulfate)
| blackbox = <span style="color:#b00020;">'''Yes'''</span> (see Safety)
| antidote = Calcium gluconate for magnesium toxicity.
| pregnancy = Used in obstetric care.
}}

<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
</div>

'''Obstetric agents (magnesium, steroids, tocolytics, fertility)''' &mdash; Obstetric agents; Electrolyte and anticonvulsant (magnesium), corticosteroids, beta agonist tocolytic, ovulation stimulant.

== Identification ==
* '''Therapeutic class:''' Obstetric agents.
* '''Pharmacologic class:''' Electrolyte and anticonvulsant (magnesium), corticosteroids, beta agonist tocolytic, ovulation stimulant.

== Pharmacology ==
* '''Mechanism of action:''' Magnesium prevents and treats eclamptic seizures and relaxes the uterus; corticosteroids accelerate fetal lung maturity; terbutaline relaxes the uterus; clomiphene stimulates ovulation.
* '''Onset / peak / duration:''' Magnesium IV onset rapid; betamethasone effect over 24 to 48 hours.
* '''Half-life / therapeutic level:''' Magnesium therapeutic range for preeclampsia about 4 to 7 mEq/L.

== Clinical use ==
* '''Indications:''' Preeclampsia and eclampsia seizure prevention and preterm labor (magnesium), fetal lung maturity (steroids), short-term tocolysis (terbutaline, magnesium), infertility (clomiphene).
* '''Usual dose, route, frequency:''' Magnesium IV loading then infusion; betamethasone IM two doses; clomiphene PO for 5 days.
* '''Maximum dose / adjustments:''' Titrate magnesium to level and reflexes; reduce in renal impairment.

== Safety ==
* '''Contraindications:''' Magnesium in heart block or myasthenia gravis; terbutaline for prolonged tocolysis.
* '''Black box warning:''' Terbutaline carries a boxed warning against prolonged tocolytic use (maternal cardiac events and death).
* '''Interactions:''' Magnesium with calcium channel blockers (hypotension) and neuromuscular blockers (enhanced).
* '''Pregnancy / lactation:''' Used in obstetric care.
* '''High-alert:''' Yes (magnesium sulfate).

== Adverse effects ==
* '''Common side effects:''' Magnesium causes flushing, warmth, and lethargy; terbutaline causes tachycardia and tremor.
* '''Serious effects to report:''' Magnesium toxicity (loss of deep tendon reflexes, respiratory depression, low urine output, cardiac changes).
* '''Antidote / reversal:''' Calcium gluconate for magnesium toxicity.

== Nursing process ==
* '''Assessment before administration:''' Deep tendon reflexes, respiratory rate, urine output, blood pressure, magnesium level.
* '''Interventions during therapy:''' Monitor reflexes, respirations (above 12), and urine output (above 30 mL/hr) during magnesium; keep calcium gluconate at the bedside.
* '''Monitor:''' Magnesium level, reflexes, respirations, urine output, fetal status.
* '''Evaluation / expected outcome:''' Seizure prevention or lung maturity achieved.

== Patient teaching ==
* '''Patient teaching:''' Magnesium causes warmth and flushing; report difficulty breathing; betamethasone protects the baby's lungs.
* '''Notify provider if:''' Not applicable for inpatient magnesium (continuous monitoring); team manages toxicity.
* '''Administration tips:''' Magnesium is high-alert; bedside calcium gluconate; monitor reflexes and respirations.

[[Category:Uterotonics and Obstetric Agents]]