magnesium sulfate (MgSO4)
Jump to navigation
Jump to search
Indications
- prevention & treatment of hypomagnesemia
- pre-eclampsia, eclampsia
- short-term treatment of postmyocardial infarction
- torsades de pointes
- pediatric acute nephritis
- prevention of cerebral palsy in premature infants?[4] (perinatal administration to mother)
Contraindications
- heart block
- severe renal insufficiency
Benefit/risk
- pre-eclampsia
- reduces risk of progression from pre-eclampsia to eclampsia (50%)[5]
- number needed to treat (NNT) = 90 for prevention of seizure[5]
- may reduce risk of maternal mortality
- no benefit for infant[5]
- 25% of women report adverse events[5]
- flushing is most common adverse effect
- number needed to harm = 200 for respiratory depression
- number needed to harm = 37 to necessitate C-section[5]
- severe asthma attack[6]
- NNT = 3 to prevent hospitalization
- no benefit is asthma attack is less than severe
- no adverse events noted[6]
Dosage
- 1 g IV every 6 hours for 4 doses
- 2 g in 50 mL D5W/NS IV over 20 min
- severe cases may require 8-12 g/day in divided doses
- maximum infusion rate 2 g/hr to avoid hypotension
Adverse effects
- depressed CNS
- blocked peripheral neuromuscular transmission
- flushing
- somnolence
- respiratory paralysis
- may accumulate in renally impaired patients
- diarrhea
- depressed deep tendon reflexes
Drug interactions
- additive CNS depression when used with:
- increased neuromuscular blockage when used with neuromuscular blocking agent
- use with caution with cardiac glycosides
Mechanism of action
cofactor in enzymatic reactions
More general terms
Component of
- magnesium sulfate/potassium sulfate/sodium sulfate (Suprep)
- magnesium sulfate/potassium chloride/sodium sulfate (Sutab)
- magnesium sulfate/potassium sulfate
- magnesium sulfate/polyethylene glycol/potassium chloride/sodium bicarbonate/sodium chloride
- cobalamin/magnesium sulfate/manganese sulfate/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine/zinc sulfate
- cobalamin/magnesium sulfate/manganese/manganese sulfate/nicotinamide/panthenol/pyridoxine/riboflavin/thiamine/zinc sulfate
- calcium chloride/glucose/magnesium sulfate/potassium chloride/sodium bicarbonate/sodium chloride/sodium phosphate
- ascorbate/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese sulfate/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/zinc sulfate
- ascorbate/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese sulfate/nicotinamide/pantothenate/polysaccharide iron complex/pyridoxine/riboflavin/thiamine/zinc sulfate
- ascorbate/cobalamin/copper/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese/manganese sulfate/nicotinamide/pantothenate/pyridoxine/riboflavin/thiamine/zinc sulfate
- ascorbate/cholecalciferol/cobalamin/copper sulfate/ferrous fumarate/folic acid/kelp/magnesium oxide/magnesium sulfate/nicotinamide/pyridoxine/riboflavin/vitamin a/zinc sulfate
- ascorbate/biotin/cobalamin/copper sulfate/ferrous fumarate/folic acid/magnesium sulfate/manganese sulfate/nicotinic acid/pantothenate/polysaccharide iron complex/pyridoxine/riboflavin/thiamine/zinc sulfate
- magnesium sulfate/potassium chloride/potassium phosphate/sodium chloride/sodium phosphate
- magnesium sulfate/potassium sulfate/prolyl endopeptidase
- Elliotts B Solution (buffered intrathecal electrolyte/dextrose injection)
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 Rouse DJ et al. A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med 2008 Aug 28; 359:895. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18753646
Stanley FJ and Crowther C. Antenatal magnesium sulfate for neuroprotection before preterm birth? N Engl J Med 2008 Aug 28; 359:962. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18753653 - ↑ 5.0 5.1 5.2 5.3 5.4 5.5 The NNT: Magnesium Sulfate for Women with Preeclampsia http://www.thennt.com/nnt/magnesium-for-pre-eclampia/
Duley L, Glmezoglu AM, Henderson-Smart DJ, Chou D Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev. 2010 Nov 10;(11):CD000025 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21069663 - ↑ 6.0 6.1 6.2 The NNT: Intravenous Magnesium Sulfate Given During an Asthma Attack. http://www.thennt.com/nnt/magnesium-sulfate-for-asthma-attack/
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr Magnesium sulfate for treating exacerbations of acute asthma in the emergency department. Cochrane Database Syst Rev. 2000;(2):CD001490. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10796650