In the active seizure phase of eclampsia, which regimens are listed as acceptable for magnesium sulfate therapy?

• A. Magnesium sulfate: 4 g IV/IO in 100 mL with 10 drop set and run wide open
• B. Magnesium sulfate: 2 g IM (4 mL) in lateral thigh
• C. Labetalol: 20 mg IV Push
• D. All of the above

Answer: (D)

During the active seizure phase of eclampsia, rapid seizure control with magnesium sulfate and concurrent management of severe hypertension are both essential. Magnesium sulfate can be given as a loading dose followed by maintenance dosing, and it can be administered by different routes depending on the setting. A 4 g IV loading dose delivered through an IV line with a standard drop set provides a quick rise in magnesium levels to stop seizures. If IV access isn’t readily available, a 2 g IM dose in the lateral thigh offers an alternative route to achieve the same therapeutic goal. In addition, controlling blood pressure with an agent like labetalol given IV push is a common part of the overall treatment plan during this critical phase. Because these approaches are all used in managing eclampsia during active seizures, the combination of these regimens is considered acceptable in that context.