Magnesium Sulfate Drug Study
Classification: Therapeutic: mineral and electrolyte replacements/supplements. Pharmacologic: minerals/electrolytes
Indications
Treatment/prevention of hypomagnesemia. Treatment of hypertension. Anticonvulsant associated with severe eclampsia, pre-eclampsia, or acute nephritis. Unlabeled uses: Preterm labor. Treatment of Torsade de pointes. Adjunctive treatment for bronchodilation in moderate to severe acute asthma.
Mechanism of Action
Essential for the activity of many enzymes. Plays an important role in neurotransmission and muscular excitability. Therapeutic Effects: Replacement in deficiency states. Resolution of eclampsia.
Contraindications/Precautions
Contraindicated in: Hypermagnesemia; Hypocalcemia; Anuria; Heart block; Active labor or within 2 hr of delivery (unless used for preterm labor). Use Cautiously in: Any degree of renal insufficiency; Digitalized patients.
Adverse Reactions/Side Effects
CNS: drowsiness. Resp: decreased respiratory rate. CV: arrhythmias, bradycardia, hypotension. GI: diarrhea.MS:muscle weakness. Derm: flushing, sweating. Metab: hypothermia.
Route/Dosage
Treatment of Deficiency (expressed asmg of Magnesium)
IM, IV (Adults): Severe deficiency—8–12 g/day in divided doses;mild deficiency—1 g q 6hr for 4 doses or 250 mg/kg over 4 hr. IM, IV (Children >1 month): 25–50 mg/kg/dose q 4–6 hr for 3–4 doses, maximum single dose: 2 g. IV (Neonates): 25–50 mg/kg/dose q 8–12 hr or
2–3 doses.
Seizures/Hypertension
IM, IV (Adults): 1 g q 6 hr for 4 doses as needed. IM, IV (Children): 20–100 mg/kg/dose q 4–6hr as needed, may use up to 200 mg/kg/dose in severe cases.
Eclampsia/Pre-Eclampsia
IV, IM (Adults): 4–5 g by IV infusion, concurrently with up to 5 g IM in each buttock; then 4–5 g IMq 4 hr or 4 g by IV infusion followed by 1–2 g/hr continuous infusion (not to exceed 40 g/day or 20 g/48 hr in the presence of severe renal insufficiency).
Nursing Management
1. Hypomagnesemia/Anticonvulsant: Monitor pulse, blood pressure, respirations, and ECG frequently throughout administration of parenteral magnesium sulfate. Respirations should be at least 16/min before each dose.
2. Monitor neurologic status before and throughout therapy. Institute seizure precautions. Patellar reflex (knee jerk) should be tested before each parenteral dose of magnesium sulfate. If response is absent, no additional doses should be administered until positive response is obtained.
3. Monitor intake and output ratios. Urine out put should be maintained at a level of at least 100 ml/4 hr.
4. Explain purpose of medication to patient and family.
Indications
Treatment/prevention of hypomagnesemia. Treatment of hypertension. Anticonvulsant associated with severe eclampsia, pre-eclampsia, or acute nephritis. Unlabeled uses: Preterm labor. Treatment of Torsade de pointes. Adjunctive treatment for bronchodilation in moderate to severe acute asthma.
Mechanism of Action
Essential for the activity of many enzymes. Plays an important role in neurotransmission and muscular excitability. Therapeutic Effects: Replacement in deficiency states. Resolution of eclampsia.
Contraindications/Precautions
Contraindicated in: Hypermagnesemia; Hypocalcemia; Anuria; Heart block; Active labor or within 2 hr of delivery (unless used for preterm labor). Use Cautiously in: Any degree of renal insufficiency; Digitalized patients.
Adverse Reactions/Side Effects
CNS: drowsiness. Resp: decreased respiratory rate. CV: arrhythmias, bradycardia, hypotension. GI: diarrhea.MS:muscle weakness. Derm: flushing, sweating. Metab: hypothermia.
Route/Dosage
Treatment of Deficiency (expressed asmg of Magnesium)
IM, IV (Adults): Severe deficiency—8–12 g/day in divided doses;mild deficiency—1 g q 6hr for 4 doses or 250 mg/kg over 4 hr. IM, IV (Children >1 month): 25–50 mg/kg/dose q 4–6 hr for 3–4 doses, maximum single dose: 2 g. IV (Neonates): 25–50 mg/kg/dose q 8–12 hr or
2–3 doses.
Seizures/Hypertension
IM, IV (Adults): 1 g q 6 hr for 4 doses as needed. IM, IV (Children): 20–100 mg/kg/dose q 4–6hr as needed, may use up to 200 mg/kg/dose in severe cases.
Eclampsia/Pre-Eclampsia
IV, IM (Adults): 4–5 g by IV infusion, concurrently with up to 5 g IM in each buttock; then 4–5 g IMq 4 hr or 4 g by IV infusion followed by 1–2 g/hr continuous infusion (not to exceed 40 g/day or 20 g/48 hr in the presence of severe renal insufficiency).
Nursing Management
1. Hypomagnesemia/Anticonvulsant: Monitor pulse, blood pressure, respirations, and ECG frequently throughout administration of parenteral magnesium sulfate. Respirations should be at least 16/min before each dose.
2. Monitor neurologic status before and throughout therapy. Institute seizure precautions. Patellar reflex (knee jerk) should be tested before each parenteral dose of magnesium sulfate. If response is absent, no additional doses should be administered until positive response is obtained.
3. Monitor intake and output ratios. Urine out put should be maintained at a level of at least 100 ml/4 hr.
4. Explain purpose of medication to patient and family.
Categories:
Drug Study
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