Drugs used in the management of toxemia of pregnancy.

Drugs used in the management of pregnancy-induced hypertension have been reviewed, and their value and adverse effects on both mother and fetus have been considered. Although magnesium and hydralazine remain the stalwarts of therapy, a number of other drugs have potential that may be realized in the future. Several new medications have promise in correcting the derangements of toxemia, but safety for the fetus has yet to be demonstrated. For the physician confronted with the complexities of old and new drugs in toxemia of pregnancy, the prayer of Lord Berkely may be just as appropriate in 1977 as it was dicades ago: From inability to let well enough alone, From too much zeal for the new, From too much contempt for what is old, From putting knowledge before wisdom and science before art, From making the cure of the disease more grievous than its endurnace, Good Lord, deliver us.

Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 47-1972.

PIP: A 65-year-old woman was admitted to the hospital because of dyspnea. 15 years previously biopsy of an enlarged left cervical lymph node revealed giant-follicle lymphoma; the patient received radiation. 7 years before a right radical mastectomy was performed for an adenocarcinoma of the breast; there were metastases to several anxillary lymph nodes. 4 years before, a malignant lymphoma was discovered again and radiation successfully given. 5 months before admission there was an onset of severe dyspnea. Upon admission, the temperature was 36.9 degrees C, pulse 100, and respirations 32. Blood pressure was 120/70. Oxygen, prednisone, furosemide, chlordiazepoxide, and morphine were administered. The woman died the 2nd day. Clinical diagnoses showed that the woman died of carcinoma of the breast with metastoses to mediastinal lymph nodes, the chest wall and the lungs, and that lymphoma was inactive. Radiation may have caused the late malignant tumor. A late radiation-induced complication may be another malignant tumor. It is noted that radiation therapy may be a calculated risk in some cases.^ieng