MAGNESIUM SULPHATE

BY ROSEMARY PALMER RN, RM, BSc Hons (Sport science & administration), ADM

ACTION

Magnesium is essential for functioning of many enzymes neurotransmission & muscle excitability

PRESENTATION & STORAGE

1 gram in 2 ml vial Store BELOW 25 oC

INDICATIONS FOR USE

Treatment for eclampsia Prophylactic treatment for pre-eclampsia (proteinurc)

Prophylactic treatment for imminent eclampsia

Can also be used to stop contractions, for the treatment of Hypoxic Ischaemic Encephalopathy of neonates and nebulised for asthmatic treatment

CONTRAINDICATIONS

Impaired renal function excreted via urine Heart block or myocardium malfunction Liver damage

SIDE EFFECTS

Rapid administration can lead to hypotension Facial flushing Nasal stuffiness Chest pain

OVERDOSE EFFECTS

Loss of tendon reflexes Respiratory Depression Drowsiness Cardiac arrythmia and cardiac arrest rapid infusion requires ECG monitoring and anaesthetist.

ANTIDOTE

Calcium Gluconate 10% slution ( 1 vial) 10ml IVI slowly

DOSAGE

For imminent eclampsia/ pre-eclampsia / eclampsia DISTRICT: (because limited monitoring): 5g (10ml) IMI in each buttock and 4g (8ml) in 200ml NaCl to run over 15-20 minutes. (14g total) 2nd LEVEL: 6g IV slow bolus the 8g in 200ml NaCl via IVAC @ 54ml /hr (14g)

Maintenance is 5g IMI alternate buttocks 4hourly x 24 hours.

DO NOT GIVE ANY OTHER DRUG IV VIA SAME LINE

FOR ECLAMPTIC CONVULSIONS

Give 4mg bolus (8ml) over 5-10 minutes then continue maintenance as above. Priority is to terminate convulsion. Mum comes first

Depends on protocol in place .

Mag Sulp does control convulsion so dont give clonazepam unless very restless

MONITORING

Urine output >30ml per hour if not can cause magnesium toxicity & renal damage and dosage needs reducing. Reflex monitoring, GCS monitoring For IV route must have ECG monitoring available