Mag Sulfate key points:

Question 1

Indications for mag sulfate

Answer 1

Severe preeclampsia

Eclampsia

Can be used in mild preeclampsia

Question 2

Loading dose for mag sulfate:

Answer 2

4-6gm over 15-20 minutes

Maintenance dose: 1-2g/hr

Question 3

Recurrent seizure:

Answer 3

administer mag

if already on mag- administer a loading dose of 2 g

If seizures persist after a 2nd loading dose, consider

• Lorazepam 4mg IV
• Diazepam 5-10 mg IV
• Midazolam 1-2mg IV
• Phenytoin 1,000 mg IV

Question 4

Target level for mag

Answer 4

4.8-8.4mg/dL

Question 5

Discontinue magnesium sulfate and obtain stat serum mag level if

Answer 5

absent DTR

Respiratory rate <12 breaths/min

Complaint of SOB

Apnea

Oliguria

Question 6

Mag toxicity interventions

Answer 6

Calcium gluconate 1g IV over 30 minutes

calcium chloride 500mg of 10% solution IV over 5-10 mins

Question 7

Discontinuation of therapy:

Answer 7

severe preeclampsia
- 24 hrs after delivery or pt shows signs of improvement (diuresis)

• eclampsia
  : 24 hrs after delivery or if postpartum, 24 hrs after last seisure

Question 8

Mag sulfate is contraindicated in patients with

Answer 8

Myasthenia Gravis

Question 9

renal insufficiency

Answer 9

serum insufficiency >1.2 mg/dl