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Magnesium Sulfate

Antiarrhythmic

Smooth muscle relaxant

ACP: Treatment of ventricular fibrillation and ventricular tachycardia refractory to first-line antiarrhythmics

ACP: Recurrent, intermittent episodes of wide-complex tachycardia

ACP: Treatment of Torsades de Pointes

ACP: Bronchospasm refractory to bronchodilation in acute asthma

ACP: Management of seizures in pregnancy associated with hypertension

 

  • Hypersensitivity to magnesium sulfate
  • Second or third-degree AV block

ACP: Control of ventricular arrhythmias (including Torsades de Pointes)

  • For perfusing rhythms: 2 g IV over 15 minutes 
  • In cardiac arrest: 4 g IV push

ACP: Bronchospasm refractory to bronchodilation

  • 2 g IV over 20 minutes

ACP: Management of seizures in pregnancy associated with hypertension

Follow weight-based dosing

ACP: All indications

  • In cardiac arrest: 50 mg/kg IV/IO push to maximum of 2 g
  • All other causes: 50 mg/kg IV/IO infused over 15 minutes

The precise mechanism of action of magnesium sulfate is not entirely clear.  It appears to alter membrane potential, slowing conduction and relaxing smooth muscle. 

Following intravenous administration: 

  • Onset: 1-2 minutes
  • Peak: < 5 minutes
  • Duration: uncertain in most patients

Infusions may take up to 20-30 minutes to produce significant bronchodilation

May prolong the effects of non-depolarizing neuromuscular blockers, and may potentiate the effects of calcium channel blockers

 

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