Eclampsia: Magnesium sulfate 4 to 6 g in a 10% or 20% solution over 3 to 4 minutes Magnesium sulfate is the drug of choice for treating eclampsia and can be used as prophylaxis against it, as well. Magnesium can reduce the risk of eclampsia by more than 50%, and it may in fact reduce maternal death.
Full Answer
How much MgSO4 IV should I give for high magnesium levels?
If Magnesium level is 1.7 to 2, give 2 grams of MgSO4 IV. If Magnesium level is 1.3 to 1.7 give 4 grams of MgSO4 IV.
Which patients with renal insufficiency may require lower doses of magnesium?
Renal insufficiency (CLcr < 20ml/min) may require lower doses of magnesium. Caution should be used when replacing magnesium in any patient with renal insufficiency.
Is a continuous magnesium infusion necessary in the emergency department?
To keep intracellular magnesium levels higher, infusions are theoretically necessary. But, it may not be logistically feasible to maintain a continuous magnesium infusion in the ED, especially considering there is not much available supporting data.
How much magnesium do you give for convulsions?
In emergencies such as convulsions or ventricular arrhythmias, a bolus injection of 1.0 gm (8.1 meq) of MgSO4 is indicated. Therapy of Mg deficiency in the presence of renal insufficiency requires smaller doses and frequent monitoring.
What is a magnesium IV used for?
MAGNESIUM SULFATE (mag NEE zee um SUL fate) is an electrolyte injection commonly used to treat low magnesium levels in your blood. It is also used to prevent or control seizures in women with preeclampsia or eclampsia.
Can magnesium be given IVP?
To initiate therapy, 4 g of Magnesium Sulfate in Water for Injection may be administered intravenously. The rate of I.V. infusion should generally not exceed 150 mg/minute, or 3.75 mL of a 4% concentration (or its equivalent) per minute, except in severe eclampsia with seizures.
Why is magnesium given for torsades?
Pulseless torsades should be defibrillated. Intravenous magnesium is the first-line pharmacologic therapy in Torsades de Pointes. Magnesium has been shown to stabilize the cardiac membrane, though the exact mechanism is unknown. The recommended initial dose of magnesium is a slow 2 g IV push.
What is the therapeutic level of magnesium treatment for pre-eclampsia?
However, Chinese guidelines for the diagnosis and treatment of hypertension and preeclampsia in pregnancy recommend the therapeutic serum magnesium level of 1.8–3.0 mmol/L, with a loading dose 2.5–5 g and a maintenance dose of 1–2 g/h for 6–12 h [4].
When do you give magnesium sulphate in preeclampsia?
Magnesium sulfate usually takes effect immediately. It's normally given until about 24 hours after delivery of the baby. Women receiving magnesium sulfate are hospitalized for close monitoring of the treatment. We're here for you.
Why is magnesium sulphate used in preeclampsia?
It is also utilized for prophylactic treatment in all patients with severe preeclampsia. The mechanism of action of magnesium sulfate is thought to trigger cerebral vasodilation, thus reducing ischemia generated by cerebral vasospasm during an eclamptic event.
What happens if you give IV magnesium too fast?
In patients with a pulse, it's recommended to give 1-2 grams of magnesium in adults (or 25-50 mg/kg/dose with a maximum of 2 grams) over 15 minutes in pediatric patients. This is because overly rapid administration can cause hypotension and even asystole- risks we don't want to take in an already tenuous situation.
How fast can you give magnesium in torsades?
Magnesium can be given at 1-2 g IV initially in 30-60 seconds, which then can be repeated in 5-15 minutes. Alternatively, a continuous infusion can be started at a rate of 3-10 mg/min. Magnesium is effective even in patients with normal magnesium levels.
Is torsades VFIB or Vtach?
A: Torsades de pointes is a ventricular tachycardia, meaning that it is a fast heartbeat with the electrical activity from the ventricles.
Why would a patient be on magnesium sulfate?
This medication is a mineral supplement used to prevent and treat low amounts of magnesium in the blood. Some brands are also used to treat symptoms of too much stomach acid such as stomach upset, heartburn, and acid indigestion.
What is the standard treatment for eclampsia?
Eclampsia Treatment Immediate treatment, usually in a hospital, is needed to stop the mother's seizures, treat blood pressure levels that are too high, and deliver the fetus. Magnesium sulfate (a type of mineral) may be given to treat active seizures and prevent future seizures.
How does IV magnesium lower blood pressure?
Magnesium sulfate may attenuate blood pressure by decreasing the vascular response to pressor substances.
When should magnesium sufate be discontinued?
Magnesium sufate should be discontinued if delivery is no longer imminent or a maximum of 24 hours of therapy has been administered [16] Loading dose of 6 g by infusion pump over 20 to 30 minutes, followed by continuous intravenous infusion at 2 g per hour.
Can magnesium sulfate cause intoxication?
Parenteral use of magnesium sulfate in the presence of renal insu fficiency may lead to magnesium intoxication. Parenteral administration of the drug is contraindicated in patients with heart block or myocardial damage , and myasthenia gravis. Treatment of preeclampsia and eclampsia [1-3,12,13 ]
Warnings
Administration during 2 hours preceding delivery for mothers with toxemia of pregnancy
Pregnancy & Lactation
Fetal skeletal demineralization, hypocalcemia, and hypermagnesemia reported with continuous long-term use (ie, longer than 5-7 days) for off-label treatment of preterm labor in pregnant women; the effect on the developing fetus may result in neonates with skeletal abnormalities
Pharmacology
Depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects; decreases amount of acetylcholine released at end-plate by motor nerve impulse
Administration
Additive: Amphotericin B, cyclosporine, dobutamine, polymyxin B sulfate, procaine, sodium bicarbonate
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
Is magnesium a second line?
We love magnesium in the Emergency Department. It’s been said that magnesium is second-line for everything (kind of like doxycycline).
Is magnesium good for rapid AF?
Magnesium seems to be safe and moderately effective for reducing heart rate in rapid AF. Even in the studies where magnesium was less effective than an active comparator, it still demonstrated some reduction in HR. Therefore, it seems reasonable to consider administering magnesium 2-4 gm IV as an adjunctive therapy while you are choosing between a calcium channel blocker or beta blocker as the primary rate-control agent. In some cases, you may find magnesium is enough to achieve lenient HR goals (ie, < 110 bpm). Monitor HR and BP appropriately.
Does magnesium help with heart rate?
Greater decreases in heart rate throughout the 24-hour study period were achieved with the addition of magnesium. This is important because it may not be immediately evident during an ED stay if magnesium is helping, especially when using digoxin which takes longer to work (sometimes several hours).
How much MgSO4 is in 50ml of saline?
In our pharmacy, MgSO4 comes as premix that is 1g in 50ml of Normal Saline and 2g in 100ml of Normal Saline. If you need 4 grams, they pharmacy will mix 4g in 100ml. Sometimes, if the physician wants, they can also prepare the MgSO4 in D5W. MgSO4 = Magnesium sulfate.
What does MgSO4 mean?
MgSO4 = Magnesium sulfate. If Magnesium level is 1.7 to 2, give 2 grams of MgSO4 IV. If Magnesium level is 1.3 to 1.7 give 4 grams of MgSO4 IV. Note, PO doses large enough to work will cause diarrhea in patients with a significantly low magnesium level.
How much magnesium should I take daily?
Magnesium Dosing. ( RDA) of magnesium is 4.5 mg/kg which is a total daily allowance of 350-400 mg for adult men and 280-300 mg for adult women.
How many magnesium chloride tablets should I take daily?
Tablets provide magnesium chloride for increased absorption versus magnesium oxide. Dosing: dietary supplement: take 2 tablets daily or as directed by a physician.
What is the Mg balance?
Mg balance is primarily a renal function (Mg intake does not appear to be regulated). The average diet provides 20 - 30 mEq daily, but the net absorption is only about 7 mEq. The kidneys normally excrete an equal amount in order to maintain Mg balance.
What is the function of Mg++?
It is essential for the optimal function of over 300 key enzymes involved in energy transformation, protein synthesis and nucleic acid metabolism.
What are the symptoms of hypomagnesemia?
Neural and neuromuscular abnormalities are the most common clinical signs of hypomagnesemia. Lowered excitability threshold may be manifested as irritability, psychosis, esophageal spasms (leading to dysphagia), and convulsions. Neuromuscular manifestations include tremor, fasciculations, and tetany.