General High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. Pronunciation: Ther. Class. mineral and electrolyte replacements/supplements Pharm. Class. minerals electrolytes Unlabeled Use(s): Action Therapeutic Effect(s): Absorption: IV administration results in complete
bioavailability; well absorbed from IM sites. Distribution: Widely distributed. Crosses the placenta and is present in breast milk. Metabolism and Excretion: Excreted primarily by the kidneys. Half-life: Unknown. TIME/ACTION PROFILE (anticonvulsant effect)
Contraindication/PrecautionsContraindicated in:
Use Cautiously in:
Adverse Reactions/Side EffectsCV: arrhythmias, bradycardia, hypotension Derm: flushing, sweating GI: diarrhea Metabolic: hypothermia MS: muscle weakness Neuro: drowsiness Resp: ↓ respiratory rate * CAPITALS indicate life-threatening. InteractionsDrug-Drug May potentiate calcium channel blockers and neuromuscular blocking agents. Route/DosageTreatment of Deficiency IM IV (Adults): Severe deficiency– 8–12 g/day in divided doses; mild deficiency– 1 g every 6 hr for 4 doses or 250 mg/kg over 4 hr. IM IV (Children >1 mo): 25–50 mg/kg/dose every 4–6 hr for 3–4 doses, maximum single dose: 2 g. IV (Neonates): 25–50 mg/kg/dose every 8–12 hr for 2–3 doses. Seizures Associated with Eclampsia/Pre-Eclampsia IV (Adults): 4–6 g loading dose over 15–30 min at onset of labor or induction/cesarean delivery, followed by 1–2 g/hr continuous infusion for ≥24 hours after delivery (max infusion rate = 3 g/hr). If seizure occurs while receiving magnesium, an additional bolus of 2–4 g may be administered over ≥5 minutes. Max dose = 40 g/24 hr. IM (Adults): 10 g loading dose administered as 5 g in each buttock at onset of labor or induction/cesarean delivery, followed by 5 g every 4 hours for ≥24 hours after delivery. Torsades de Pointes IV (Infants and Children): 25–50 mg/kg/dose, maximum dose: 2 g. Bronchodilation IV (Adults): 2 g single dose. IV (Children): 25 mg/kg/dose, maximum dose: 2 g. Parenteral Nutrition IV (Adults): 4–24 mEq/day. IV (Children): 0.25–0.5 mEq/kg/day. Availability (generic available)Solution for injection (8.1 mEq Mg/g): 500 mg/mL (50%) Premixed infusion: 1 g/100 mL, 2 g/50 mL, 4 g/50 mL, 4 g/100 mL, 20 g/500 mL, 40 g/1000 mL Assessment
Lab Test Considerations: Monitor serum magnesium levels and renal function periodically during administration of parenteral magnesium sulfate. Implementation
IV Administration
Patient/Family Teaching
Evaluation/Desired Outcomes
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