Magnesium sulfate

Question 1

What are the indications for use of magnesium sulfate?

Answer 1

❑ Refractory ventricular fibrillation/tachycardia with suspected hypomagnesemia (alcoholism, malnutrition or protracted diarrhea)
❑ Polymorphic ventricular tachycardia / Torsades de Pointes
❑ Life threatening ventricular arrhythmias due to digitalis toxicity
❑ Hypomagnesemia
❑ Adjunctive therapy in severe bronchospasm refractory to nebulized medications
❑ Tricyclic Antidepressant (TCA) overdose
❑ Moderate to severe eclampsia symptoms
❑ Preterm Tocolytic – Medical Control

Question 2

What is the dosage of magnesium sulfate in cardiac arrest (Refractory VF/pVT due to hypomagnesaemia or Torsades de Pointes)?

Answer 2

Adult: 1-2 g IVP dilute in 10 mL NS
Pediatric: 20 – 50mg/kg IVP

Question 3

What is the dose of magnesium sulfate for use in Torsades de Pointes with a pulse, Hypomagnesemia, or life threatening ventricular arrhythmias due to digitalis toxicity?

Answer 3

Loading dose: 1 - 2 g IV diluted in 50 ml of NS given over 5 – 60 minutes; Follow with 0.5 – 1 g/hr IV (titrate rate to control torsades).

Question 4

What is the dose for magnesium sulfate for use in Bronchospasm / TCA Overdose?

Answer 4

Adult: 1 - 2g IV in 50 ml NS over 10 min
Pediatric: 25 - 50mg/kg IV in 50mL NS over 10min

Question 5

What is the dose of magnesium sulfate for use in Eclampsia/Tocolytic?

Answer 5

Loading dose: 4 g IV/IO in 50 ml NS over 20 minutes

Maintenance dose: 2 g/Hr in 250 ml NS over 60 min

Question 6

What are contraindications to magnesium sulfate use?

Answer 6

• Heart Blocks
• Renal failure
• Pregnant women in actively progressing labor