Magnesium Sulfate

Question 1

Magnesium Sulfate Trade Name

Answer 1

None noted

Question 2

Magnesium Sulfate Classification

Answer 2

Medscape:
Mineral, electrolyte, Antidysrhythmics V

Question 3

Magnesium Sulfate Mechanism

Answer 3

Medscape:
Depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects; decreases amount of acetylcholine released at end-plate by motor nerve impulse.

Slows rate of SA node impulse formation in myocardium and prolongs conduction time

Promotes movement of calcium, potassium, and sodium in and out of cells and stabilizes excitable membranes

Promotes osmotic retention of fluid in colon, causing distention and increased peristaltic activity, which subsequently results in bowel evacuation

Capital:
Physiological calcium channel blocker; reduces neuromuscular impulse transmission and causes smooth muscle relaxation.

Question 4

Magnesium Sulfate Onset of Action

Answer 4

Capital: Immediate

Question 5

Magnesium Sulfate Duration of Action

Answer 5

Capital: Variable

Question 6

Magnesium Sulfate Indications

Answer 6

CT Protocols:
* Elemental electrolyte used to treat eclampsia during the third trimester of pregnancy.
* A smooth muscle relaxer used in refractory respiratory distress resistant to beta-agonists.
* Torsades de Pointes.

Capital:
Severe bronchospasm associated with asthma and COPD, Torsades de Pointes, Eclamptic, seizures, Hypomagnesemia, VF/VT arrest refractory to amiodarone, Dysrhythmia due to digitalis toxicity

Question 7

Magnesium Sulfate Contraindications

Answer 7

Capital:
Heart block, Persistent hypertension, Dialysis patients, Hypocalcemia

Question 8

Magnesium Sulfate Side Effects/ Precautions/ Comments

Answer 8

Capital:
CNS depression, Respiratory depression, Paralysis, Bradycardia, Burning at injection site, Decreased reflexes, Nausea/vomiting, Hypotension, Vasodilation, Itching/rash

IV calcium chloride or gluconate is the antidote to magnesium toxicity and should be available for administration

Question 9

Magnesium Sulfate Adult Dose

Answer 9

CT Protocols:
Asthma/COPD/RAD
2 grams in 100ml NS given IV/IO over 10 minutes

Seizures
Magnesium sulfate, 4 grams IV/IO bolus over 10 minutes, then consider 1 gram/hr continuous infusion.

Cardiac Arrest/Tachycardia – Torsades de Pointes.
1 – 2 grams IV/IO over 5 minutes.

Question 10

Magnesium Sulfate Pediatric Dose

Answer 10

Capital:
25-50 mg/kg in 100 ml over 10 minutes; max 2g

Question 11

Magnesium Sulfate
Max Dose Adult (Pediatric)

Answer 11

2g for asthma, 4g seizures (2g)

Question 12

Magnesium Sulfate Routes of Administration

Answer 12

IV/IO

Question 13

Magnesium Sulfate How Supplied

Answer 13

500mg/ml vials (50% solution)