Magnesium Sulfate

• Trade – Magnesium Sulfate
• Class – Electrolyte, Tocolytic, Mineral
• Action – Controls seizures by blocking peripheral neuromuscular transmission. Magnesium is also a peripheral vasodilator, and an inhibitor of platelet function. 
• Indication – Torsades de Pointes, cardiac arrhythmias associated with hypomagnesemia, eclampsia and seizure prophylaxis in preeclampsia, status asthmaticus. 
• Contraindications – AV Block, GI obstruction, use caution in renal impairment. 
• Side effects – Mag Toxicity

Signs of Mag Toxicity would include flushing, diaphoresis, hypotension, muscle paralysis, weakness, hypothermia, and cardiac, CNS, or respiratory depression

• Dosages

Pulseless V-fib/ V-tach with Torsades de Pointes or Hypomagnesemia 

Adult:1 – 2 G in 10ml D5W IV,IO, over 15 mins or faster if cardiac arrest

Pediatric: 25 – 50mg/kg IV/IO over 10 – 20 mins or faster for Torsades- max single dose: 2G

Eclampsia and Seizure Prophylaxis in preeclampsia 

Adult:4-6G IV/O over 20-30 mins followed by 1-2G/Hr 

Status Asthmaticus 

Adult: 1.2-2G IV/IO over 20 mins

Pediatric:25/50mg/kg slow IV/IO over 10-20 mins