Difference between revisions of "Magnesium sulfate"

(General)
(References)
 
(7 intermediate revisions by 4 users not shown)
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*Dosage Forms: IV
 
*Dosage Forms: IV
 
*Common Trade Names:
 
*Common Trade Names:
*<ref>Severe Hypokalemia should warrant checking of Magnesium level and correction if required.</ref>
 
  
 
==Adult Dosing==
 
==Adult Dosing==
*Loading dose = 1-2gm in 10mL D5W over 1-2min (cardiac arrest)
+
*Loading dose = 1-2gm in 10mL D5W over 1-2min ([[cardiac arrest]])
 
*Loading dose = 1-4gm in 50-100 D5W over 20-60min (spontaneous circulation)
 
*Loading dose = 1-4gm in 50-100 D5W over 20-60min (spontaneous circulation)
  
*Eclampsia:
+
===[[Eclampsia]]===
**Initial: 4 g magnesium sulfate 50% solution (400mg elemental magnesium) to a 10% or 20% solution and give IV over 3 to 4 minutes OR 5mg IM in each buttock
+
*Initial: 4 g magnesium sulfate 50% solution (400mg elemental magnesium) to a 10% or 20% solution and give IV over 3 to 4 minutes '''OR''' 5mg IM in each buttock
**Maintenance: 1 to 2 g/hr IV until paroxysms cease
+
*Maintenance: 1 to 2 g/hr IV until paroxysms cease
  
===Indications===
+
==Pediatric Dosing==
*Torsades
+
*[[Torsades]]: 25 to 50mg/kg rapid infusion over several minutes
*Refractory v-tach/fib (regardless of Mg level)
 
*Eclampsia
 
*Hypomagnesemia
 
*Barium poisoning
 
  
==Pediatric Dosing==
 
*Torsades: 25 to 50mg/kg rapid infusion over several minutes
 
 
===Cardiac===
 
===Cardiac===
 
*25-50mg/kg IV x 1
 
*25-50mg/kg IV x 1
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==Special Populations==
 
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D (despite being drug of choice for eclampsia!)
+
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D (despite being drug of choice for [[eclampsia]]!)
 
*Lactation: infant risk minimal
 
*Lactation: infant risk minimal
 
*Renal Dosing: for severe renal impairment, max dose 20g/48 hours
 
*Renal Dosing: for severe renal impairment, max dose 20g/48 hours
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**Adult
 
**Adult
 
**Pediatric
 
**Pediatric
 +
 +
==Indications==
 +
*[[Torsades]]
 +
*Refractory v-tach/fib (regardless of Mg level)
 +
*[[Eclampsia]]
 +
*[[Hypomagnesemia]]
 +
*Barium poisoning
  
 
==Contraindications==
 
==Contraindications==
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==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
*Hypotension (rare)
+
*[[Hypotension]](rare)
 
*Heart block
 
*Heart block
 
*CNS depression
 
*CNS depression
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==References==
 
==References==
 +
<references/>
  
<references/>
 
 
[[Category:Pharmacology]]
 
[[Category:Pharmacology]]
* 1. Chou-Long Huang and Elizabeth Kuo . Mechanism of Hypokalemia in Magnesium Deficiency. J. Am. Soc. Nephrol. 2007 18: 2649-2652.
+
[[Category:FEN]]
 +
[[Category:Cardiology]]

Latest revision as of 23:05, 22 September 2019

See critical care quick reference for drug doses by weight.

General

Adult Dosing

  • Loading dose = 1-2gm in 10mL D5W over 1-2min (cardiac arrest)
  • Loading dose = 1-4gm in 50-100 D5W over 20-60min (spontaneous circulation)

Eclampsia

  • Initial: 4 g magnesium sulfate 50% solution (400mg elemental magnesium) to a 10% or 20% solution and give IV over 3 to 4 minutes OR 5mg IM in each buttock
  • Maintenance: 1 to 2 g/hr IV until paroxysms cease

Pediatric Dosing

  • Torsades: 25 to 50mg/kg rapid infusion over several minutes

Cardiac

  • 25-50mg/kg IV x 1

See critical care quick reference for drug doses by weight.

Special Populations

  • Pregnancy Rating: D (despite being drug of choice for eclampsia!)
  • Lactation: infant risk minimal
  • Renal Dosing: for severe renal impairment, max dose 20g/48 hours
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Indications

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Onset of action = Immediate
  • Duration of action = 30min
  • Metabolism:
  • Excretion: Renal

Mechanism of Action

  • Increases vasomotor tone
  • Prolongs AV conduction; prolongs refractoriness

See Also

References