Professional Documents
Culture Documents
Magnesium Sulfate
Magnesium Sulfate
Magnesium Sulfate
Onset
Trade Names
Epsom Salt
- Granules, oral
Magnesium Sulfate
- Injection, solution 4% (elemental magnesium 0.325 mEq/mL)
- Injection, solution, concentrate 8% (elemental magnesium
0.65 mEq/mL)
- Injection, solution, concentrate 50% (elemental magnesium 4
mEq/mL)
Duration
30 min (IV, when used as an anticonvulsant); 3 to 4 h (IM).
Special Populations
Renal Function Impairment
No data available.
Pharmacology
No data available.
Pharmacokinetics
Absorption
Immediately absorbed (IV).
Distribution
Approximately 1% to 2% of total body magnesium is in the
extracellular fluid space; 30% bound to albumin.
Metabolism
Magnesium is not metabolized.
Elimination
Unlabeled Uses
Treatment of acute exacerbation of severe asthma; treatment of
torsades de pointes; paroxysmal atrial tachycardia; cerebral
edema; barium poisoning.
Contraindications
Toxemia of pregnancy during 2 h preceding delivery.
Hyperalimentation
Adults
TPN 5 to 8 mEq of magnesium per 1 L of TPN solution. Typical
daily intakes range from 10 to 24 mEq/day.
Children
TPN 0.25 to 0.6 mEq/kg/day.
Hypomagnesemia
Adults Mild hypomagnesemia
IM 1 g (2 mL of undiluted 50% solution) injected every 6 h for 4
doses.
Severe hypomagnesemia
IV / IM As much as 246 mg/kg (0.5 mL/kg of the undiluted 50%
solution) may be given within a period of 4 h if necessary.
Alternatively, 5 g (10 mL) can be added to 1 L of dextrose 5%
injection or sodium chloride 0.9% injection for slow IV infusion
over a 3-h period. According to American Heart Association
(AHA) guidelines, the recommended dosage is 1 to 2 g IV over
5 to 60 min. If seizures are present, give 2 g IV over 10 min.
Use caution so as not to exceed the renal excretion capacity.
Laxative
Usually a one-time dose.
PO 10 to 15 g.
Children
PO 5 to 10 g.
Seizures in Eclampsia/Preeclampsia
Children
Adults
Nephritic Seizures
Children
General Advice
Injection
Chloroquine, eltrombopag:
Oral magnesium sulfate
may decrease the absorption and clinical effect of
chloroquine or eltrombopag. Separate the administration
times of chloroquine and oral magnesium sulfate by 2 to 4
h. Higher doses of chloroquine may be needed. Separate
the administration times of eltrombopag and oral
magnesium sulfate by at least 4 h.
Neuromuscular blocking agents: Potentiation of
neuromuscular blockade; use with caution. Monitor for
respiratory depression. Adjust the neuromuscular blocking
agent dose as needed. Be prepared to provide life
support.
Nifedipine:
The risk of neuromuscular blockade and
hypotension may be increased. Closely monitor the clinical
response. Be prepared to provide supportive treatment or
to discontinue one or both drugs if needed.
Nitrofurantoin: Decreased absorption of nitrofurantoin (oral
magnesium). Separate the administration times by as
much as possible.
Penicillamine: Reduced penicillamine effects (oral
magnesium). No special precautions are needed.
Adverse Reactions
Cardiovascular:
CNS:
paralysis.
Metabolic:
Respiratory:
of tetany.
Storage/Stability
Store at 68 to 77F. Protect from freezing. Discard
any unused solution. Unused portions of the undiluted 50%
solution in the container should be discarded within 24 h of
initial use.
paralysis.
Miscellaneous:
Precautions
Drug Interactions
Alcohol, aminoglycosides, amphotericin B, cisplatin,
cyclosporine, digitalis, diuretics
Monitor:
Symptoms
Decreased deep tendon reflexes, disappearance of patellar
reflex, ECG changes (ie, prolonged PR interval, prolonged
QRS complex, prolonged QT interval), heart block,
hypotension, respiratory paralysis.
Patient Information
Pregnancy:
Elderly:
renal impairment.
Renal Function:
Aluminum toxicity:
Eclampsia:
threatening convulsions.
Flushing/Sweating:
and sweating occurs.
Overdosage
Oral
manufacturer.
Lactation:
Injection
Nursing Management
1. Hypomagnesemia/Anticonvulsant: Monitor pulse, blood
pressure, respirations, and ECG frequently throughout
administration of parenteral magnesium sulfate.
Respirations should be at least 16/min before each dose.
2. Monitor neurologic status before and throughout therapy.
Institute seizure precautions. Patellar reflex (knee jerk) should
be tested before each parenteral dose of magnesium sulfate. If
response is absent, no additional doses should be
administered until positive response is obtained.
3. Monitor intake and output ratios. Urine out put should be
maintained at a level of at least 100 ml/4 hr.