Difference between revisions of "Magnesium sulfate"

(Text replacement - " ==" to "==")
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==General==
 
==General==
 
*Type: [[Antiarrhythmics]]
 
*Type: [[Antiarrhythmics]]
*Dosage Forms:
+
*Dosage Forms: IV
 
*Common Trade Names:  
 
*Common Trade Names:  
  
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*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:
 +
**Initial: 4 g magnesium sulfate 50% solution (400 mg 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
 +
 
===Indications===
 
===Indications===
 
*Torsades
 
*Torsades
 
*Refractory v-tach/fib (regardless of Mg level)
 
*Refractory v-tach/fib (regardless of Mg level)
 +
*Eclampsia
 +
*Hypomagnesemia
 +
*Barium poisoning
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
 +
*Torsades: 25 to 50 mg/kg rapid infusion over several minutes
 
===Cardiac===
 
===Cardiac===
 
*25-50 mg/kg IV x 1
 
*25-50 mg/kg IV x 1
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==Special Populations==
 
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
+
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D (despite being drug of choice for eclampsia!)
*Lactation:
+
*Lactation: infant risk minimal
*Renal Dosing
+
*Renal Dosing: for severe renal impairment, max dose 20g/48 hours
 
**Adult
 
**Adult
 
**Pediatric
 
**Pediatric
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===Serious===
 
===Serious===
 
*Hypotension (rare)
 
*Hypotension (rare)
 +
*Heart block
 +
*CNS depression
 +
 
===Common===
 
===Common===
  
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*Duration of action = 30min
 
*Duration of action = 30min
 
*Metabolism:  
 
*Metabolism:  
*Excretion:  
+
*Excretion: Renal
  
 
===Mechanism of Action===
 
===Mechanism of Action===

Revision as of 03:45, 14 July 2016

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 (400 mg 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

Indications

  • Torsades
  • Refractory v-tach/fib (regardless of Mg level)
  • Eclampsia
  • Hypomagnesemia
  • Barium poisoning

Pediatric Dosing

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

Cardiac

  • 25-50 mg/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

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Hypotension (rare)
  • Heart block
  • CNS depression

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