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)
===[[Cardiac arrest]]===
*Loading dose = 1-4gm in 50-100 D5W over 20-60min (spontaneous circulation)
*Loading dose = 1-2gm in 10mL [[D5W]] over 1-2min


*Eclampsia:
===Spontaneous circulation===
**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
*Loading dose = 1-4gm in 50-100 [[D5W]] over 20-60 min
**Maintenance: 1 to 2 g/hr IV until paroxysms cease


===Indications===
===[[Eclampsia]]===
*Torsades
*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
*Refractory v-tach/fib (regardless of Mg level)
*Maintenance: 1 to 2 g/hr IV until paroxysms cease
*Eclampsia
'''OR'''
*Hypomagnesemia
*If no IV Access, give Magnesium sulfate 50% solution IM 10g Loading Dose (5g in each buttock)
*Barium poisoning
*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==
*Torsades: 25 to 50 mg/kg rapid infusion over several minutes
*[[Torsades]]: 25 to 50mg/kg rapid infusion over several minutes
 
===Cardiac===
===Cardiac===
*25-50 mg/kg IV x 1
*25-50mg/kg IV x 1
''See [[critical care quick reference]] for drug doses by weight.''
''See [[critical care quick reference]] for drug doses by weight.''


==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==
*[[QT prolongation]]
*[[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
*Respiratory depression


===Common===
===Common===
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*[[Hypermagnesemia]]
*[[Hypermagnesemia]]
*[[Hypomagnesemia]]
*[[Hypomagnesemia]]
*[[QT prolongation]]
*[[Eclampsia]]


==References==
==References==
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:FEN]]
[[Category:Cardiology]]

Latest revision as of 10:13, 20 June 2025

See critical care quick reference for drug doses by weight.

General

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

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

See Also

References