MAGNESIUM SULFATE
From CRS EMS Guidelines
Revision as of 21:46, 3 April 2022 by Cgabryszek (talk | contribs) (Created page with "'''Class''' Anticonvulsant / Antiarrhythmic '''Pharmacology and Actions''' # Cardiac: stabilizes potassium pump, correcting repolarization. Shortens the QT interval in the presence of ventricular arrhythmias due to drug toxicity or electrolyte imbalance. # Obstetrics: controls seizures by blocking neuromuscular transmission. Also lowers blood pressure and decreases cerebral vasospasm. '''Indications''' # Cardiac: ## Recommended for use in cardiac arrest only if tors...")
Class
Anticonvulsant / Antiarrhythmic
Pharmacology and Actions
- Cardiac: stabilizes potassium pump, correcting repolarization. Shortens the QT interval in the presence of ventricular arrhythmias due to drug toxicity or electrolyte imbalance.
- Obstetrics: controls seizures by blocking neuromuscular transmission. Also lowers blood pressure and decreases cerebral vasospasm.
Indications
- Cardiac:
- Recommended for use in cardiac arrest only if torsades de pointes or suspected hypomagnesemia is present.
- Refractory VF (after lidocaine).
- Torsades de pointes with a pulse
- Obstetrics: Pregnancy >20 weeks with signs and symptoms of pre-eclampsia, defined as:
- Blood pressure > 180 mm systolic or > 120 mm diastolic with altered mental status, or,
- Seizures
Precautions
- AV block
- Decrease in respiratory or cardiac function
- Use with caution in patients taking digitalis
Administration
- Torsades de pointes (not in cardiac arrest): Loading dose of 1 gram infused slowly over 60 minutes.
- In pre-eclampsia/eclampsia patients, 2 grams diluted in 100 mL of normal saline over 5-20 minutes. May repeat to a total dose of 6 grams.
Side Effects and Special Notes
- Principle side effect is respiratory depression. Ventilatory assistance may be needed.
- Not for pediatric use.
- Magnesium sulfate is very irritating when administered IV, thus dilution is always recommended.