Magnesium sulfate: Difference between revisions
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*Type: [[Antiarrhythmics]] | *Type: [[Antiarrhythmics]] | ||
*Dosage Forms: IV | *Dosage Forms: IV | ||
*Common Trade Names: | *Common Trade Names: None | ||
==Adult Dosing== | ==Adult Dosing== | ||
*Loading dose = 1-2gm in 10mL D5W over 1-2min | ===[[Cardiac arrest]]=== | ||
*Loading dose = 1-4gm in 50-100 D5W over 20- | *Loading dose = 1-2gm in 10mL [[D5W]] over 1-2min | ||
===Spontaneous circulation=== | |||
*Loading dose = 1-4gm in 50-100 [[D5W]] over 20-60 min | |||
===[[Eclampsia]]=== | ===[[Eclampsia]]=== | ||
*Initial: 4 g magnesium sulfate 50% solution | *Initial: 4-6 g IV magnesium sulfate (Dilute the 50% solution of 400mg elemental magnesium, to a 10% or 20% solution) and give over 20 to 30 minutes | ||
*Maintenance: 1 to 2 g/hr IV until paroxysms cease | *Maintenance: 1 to 2 g/hr IV until paroxysms cease | ||
'''OR''' | |||
*If no IV Access, give Magnesium sulfate 50% solution IM 10g Loading Dose (5g in each buttock) | |||
*Maintenance: followed by 5 g IM q 4 hours | |||
(Note: Use IM if no IV, No data on IO Route for Ecclampsia) | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
| Line 31: | Line 38: | ||
==Indications== | ==Indications== | ||
*[[QT prolongation]] | |||
*[[Torsades]] | *[[Torsades]] | ||
*Refractory v-tach/fib (regardless of Mg level) | *Refractory v-tach/fib (regardless of Mg level) | ||
Latest revision as of 10:13, 20 June 2025
See critical care quick reference for drug doses by weight.
General
- Type: Antiarrhythmics
- Dosage Forms: IV
- Common Trade Names: None
Adult Dosing
Cardiac arrest
- Loading dose = 1-2gm in 10mL D5W over 1-2min
Spontaneous circulation
- Loading dose = 1-4gm in 50-100 D5W over 20-60 min
Eclampsia
- Initial: 4-6 g IV magnesium sulfate (Dilute the 50% solution of 400mg elemental magnesium, to a 10% or 20% solution) and give over 20 to 30 minutes
- Maintenance: 1 to 2 g/hr IV until paroxysms cease
OR
- If no IV Access, give Magnesium sulfate 50% solution IM 10g Loading Dose (5g in each buttock)
- Maintenance: followed by 5 g IM q 4 hours
(Note: Use IM if no IV, No data on IO Route for Ecclampsia)
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
- QT prolongation
- Torsades
- Refractory v-tach/fib (regardless of Mg level)
- Eclampsia
- Hypomagnesemia
- Barium poisoning
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Hypotension (rare)
- Heart block
- CNS depression
- Respiratory 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