Name of Drug
Generic Name:
Magnesium Sulfate
Trade/Brand Name:
- Epsom Salt, magnesium
sulfate injection
Patient’s Dose:
1 g every 4 hours x 6 doses
Route:
Intramuscular
Form:
Parenteral
Maximum dose:
30 to 40g MgSO4
Minimum dose:
4g MgSO4
Availability:
- Granules (for oral use):
120 g, 4 lb
- Infusion Solution: 10
mg/ml, 20 mg/ml, 40
mg/ml, 80 mg/ml.
- Injection Solution: 125
mg/ml, 500 mg/ml.
Content:
Magnesium, Sulfur,
Oxygen
Classification Mechanism of Action
Pharmacologic Class: - In laxative action, it
Mineral increases osmotic gradient
in small intestine, which
draws water into intestines
and causes distention.
These effects stimulate
peristalsis and bowel
Therapeutic Class: evacuation.
Antacid, anticonvulsant, - In electrolyte action, it
electrolyte, laxative. is primarily found in
intracellular fluids,
Pregnancy Category: D essential for enzyme
activity, nerve conduction,
muscle contraction.
Maintains and restores
magnesium levels. - In
antacid action, reacts with
hydrochloric acid in
stomach to form water and
increase gastric pH levels.
- In anticonvulsant
action, depresses CNS and
blocks transmission of
peripheral neuromuscular
impulses, producing
seizure control.
Pharmacokinetics:
Absorption - Following
administration, 30-50% of
the dose is absorbed from
the small intestine.
Distribution - Crosses the
placenta and small
amounts enter the
breastmilk. Protein-
binding: 25-30%
Excretion - Via urine
(absorbed fraction); Via
faeces (unabsorbed
fraction).
Indication
General Indications:
- Used for
treatment/prevention of
hypomagnesemia;
prevention and treatment
of seizures in severe
preeclampsia or eclampsia;
pediatric acute nephritis,
treatment of arrhythmias
due to hypomagnesemia
(ventricular fibrillation,
ventricular tachycardia, or
torsades de points
Patient’s Indication:
Contraindication
- Hypersensitivity
- Myocardial damage
- Diabetic coma
- Heart block
- Hypermagnesemia
- Hypercalcemia
- Administration during 2
hours preceding delivery
for mothers with toxemia
of pregnancy
Drug Interaction/s:
- Aminoquinolones,
nitrofurantoin,
penicillamine,
tetracyclines: decreased
absorption of these drugs
(with oral magnesium)
- CNS depressants:
additive effects
- Digoxin: heart block,
conduction changes (with
I.V. use)
- Enteric-coated drugs:
faster dissolution of these
drugs
- Neuromuscular blockers:
increased effects of these
drugs (with I.V. use)
Side Effects Nursing Responsibilities
- CNS (with I.V. use):
confusion, decreased
reflexes, dizziness,
syncope, sedation,
hypothermia, paralysis
- CV (with I.V. use):
hypotension, arrhythmias,
circulatory collapse
- GI: nausea, vomiting,
cramps, flatulence,
anorexia
- Metabolic:
hypermagnesemia,
hypocalcemia
- Musculoskeletal (with
I.V. use): muscle
weakness, flaccidity
- Respiratory: respiratory
paralysis
- Skin: diaphoresis
- Other: allergic reaction,
injection site reaction,
laxative dependence (with
repeated or prolonged use)
Before:
- Check the doctor’s order
- Assess patients sensitivity
to magnesium
- Assess GI pain (duration,
location, quality, time of
occurrence, relief with
food,
causative/exacerbative
factors).
- Assess for weight loss,
nausea, vomiting, and
history of recent abdominal
surgery.
- Assess renal function,
serum magnesium levels.
- Perform hand hygiene and
prepare the medication.
- Educate the patient about
the drug, its benefits and
risks.
During:
- Identify the patient
- Inspect the parenteral
drug product for particulate
matter and discoloration.
- administer only the
prescribed dose for the
patient
- inform the patient about
the possible side effects.
After:
- document the drug
administered
- monitor patient’s
response to drug, as well as
the adverse effects
- discontinue drugs if
adverse effects occur
- evaluate effectiveness of
teaching plan
- Assess for relief of gastric
 distress.
- Monitor renal function
(esp. if dosing is long term
or frequent).
- Monitor daily pattern of
bowel activity, stool
consistency.

Sources: Sources:
1) Hodgson, B. B., & Sources: 1) Hodgson, B. B., &
Kizior, R. J. (2016). Sources: Sources: 1) Hodgson, B. B., & Sources: Sources: Kizior, R. J. (2016).
Saunders Nursing Drug 1) Hodgson, B. B., & 1) Hodgson, B. B., & Kizior, R. J. (2016). 1) Hodgson, B. B., & 1) Hodgson, B. B., & Saunders Nursing Drug
Handbook. Missouri: Kizior, R. J. (2016). Kizior, R. J. (2016). Saunders Nursing Drug Kizior, R. J. (2016). Kizior, R. J. (2016). Handbook. Missouri:
Elsevier. Saunders Nursing Drug Saunders Nursing Drug Handbook. Missouri: Saunders Nursing Drug Saunders Nursing Drug Elsevier.
2) MIMS(n.d.). Handbook. Missouri: Handbook. Missouri: Elsevier. Handbook. Missouri: Handbook. Missouri: 2) MIMS(n.d.). Magnesium
Magnesium Sulfate Elsevier. Elsevier. 2) MIMS(n.d.). Elsevier. Elsevier. Sulfate
https://www.mims.com/ 2) MIMS(n.d.). 2) MIMS(n.d.). Magnesium Sulfate 2) MIMS(n.d.). 2) MIMS(n.d.). https://www.mims.com/
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