Magnesium Sulfate

Aliases: None

Indications: V-Fib or Pulseless V-Tach(pVT) Cardiac Arrest, Wide Complex Tachycardia with a Pulse, All Torsade de Pointes, Respiratory Distress or Failure, OB Seizures (eclampsia)    

Contraindications: Hypotension, third degree AV block, routine dialysis patients, known hypocalcemia 

Concentrations: 

Injection: 500 mg/mL

Dosing

Adult:

Indication	Dose	Route	Note
V-fib or pVT Cardiac Arrest	2 g	Slow IV Push	Refractory VF/pVT only
-Tachycardia with a Pulse:  -AFib/AFlutter with RVR  -Torsades de Pointes  -Respiratory Distress/Failure	2 g	IV Infusion over 5 minutes
OB Seizures	4 g	IV Infusion over 5 minutes

Pediatric:

Indication	Dose	Route	Note
V-fib or pVT Cardiac Arrest	50 mg/kg Max: 2 g	Slow IV Push	Refractory VF/pVT only
-Wide Complex Tachycardia WITH a Pulse (Torsades de Pointes) -Respiratory Distress/Failure	50 mg/kg Max: 2 g	IV Infusion over 5 minutes

Precautions: Magnesium Sulfate should be administered slowly to minimize side effects. Use with caution in patients with known renal insufficiency. In hypermagnesemia Calcium Chloride should be available as an antidote if serious side effects occur 

Adverse/Side Effects: Hypotension, cardiac arrest, respiratory/CNS depression, flushing, sweating, bradycardia, decreased deep tendon reflexes, drowsiness, respiratory depression, arrhythmia, hypothermia, itching, and rash.   

Class: Antiarrhythmic (Class V), Electrolyte    

Mechanism of Action: Magnesium Sulfate is a salt that dissociates into the Magnesium cation and the sulfate anion. Magnesium is an essential element in numerous biochemical reactions that occur within the body. Magnesium Sulfate acts as a calcium channel blocker and blocks neuromuscular transmission. Hypomagnesemia can cause refractory ventricular fibrillation. Magnesium Sulfate is also a central nervous system depressant used for seizures associated with eclampsia and it is also a bronchodilator. 

Onset of Action	Peak Effect	Duration of Action
Immediate	Fast	30 minutes