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Magnesium Sulfate

MAGNESIUM SULFATE IS USED IN CARDIAC ARREST ONLY IF THE PATIENT IS POSSIBLY HYPOMAGNESEMIC OR IN TORSADES DE POINTES. Other uses include life-threatening arrhythmia as a result of digoxin toxicity.

Dosage

In cardiac arrest due to hypomagnesemia or torsades de pointes, give 1 to 2 grams IV or IO. The magnesium should be given as 2 to 4 ml. of a 50% solution, diluted in 10 ml of D5W or normal saline.

In torsades with a pulse or in the case of acute MI with suspicion of hypomagnesemia, a loading dose of 1 to 2 grams mixed in 50 to 100 ml. of D5W or normal saline should be given IV over 5 to 60 minutes. This may be followed with a dose of 0.5 to 1 gram per hour IV, titrated to control torsades de pointes.

Contraindications

Routine use in acute myocardial infarction is not recommended.

Precautions

May cause hypotension if rapidly administered.

Use cautiously in renal failure.