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Drug Data Generic Name Magnesium Sulfate Trade Name Martham Minimum Dose 1-2 g qH by IV infusion Maximum Dose 4-6 g qH by IV infusion

Contents Magnesium sulfate Availability and color - Granules- 40 mEq/5 g - Injection0.325, 0.65, 1, 4 mEq/mL Routes of administration Oral Intramuscular Intravenous

Classification Pharmacologic Class Mineral, Electrolyte Therapeutic Class Antiepileptic, Laxative; Mineral, electrolyte replacement Pregnancy Risk Factor A B (Laxative)

Mechanism of Action Cofactor of many enzyme systems involved in neurochemical transmission and muscular excitability; prevents or controls seizures by locking the neuromuscular transmission; attracts and retains the water in the intestinal lumen and distends the bowel to promote mass movement and relieve constipation. Pharmacokinetics A: Following administration, 30-50% of the dose is absorbed from the small intestine. D: Crosses the placenta and small amounts enter the breast milk. M: Unknown E: Via urine and feces. Route Oral IM IV Onset 1-2 hr 60 min Immediate Peak unknown unknown unknown Duration 3-4 hr 3-4 hr 30 min

Indication General Indications - Constipation - Torsades de pointes - Muscle stimulating effects of barium poisoning - Reduction of cerebral oedema. Hypomagnesaemia - Seizures associated with epilepsy, glomerulonephritis or hypothyroidism. - Toxemias of pregnancy - Boils and carbuncles

Contraindications Concentrations - Allergy to magnesium products - Abdominal pain - Nausea - Vomiting - Acute surgical abdomen - Fecal impaction - Intestinal and biliary tract obstruction - Hepatitis - Myocardial damage - Heart blocks - 2 hr preceding delivery Precaution - Renal insufficiency Drug interaction Drug to drug - Potentiation of neuromuscular blockade produced by nondepolarizing neuromuscular relaxants Drug to food - none reported

Adverse Reaction CNS: Weakness, drowsiness, dizziness, fainting, sweating Respiratory: Decreased respiratory rate CV: Palpitations GI: Excessive bowel activity, perianal irritation Metabolic: Magnesium intoxication, hypocalcemia with tetany

Nursing Responsibilities Before - Assess for contraindicated conditions. - Monitor knee-jerk reflex before repeated parenteral administration. - Give as laxative as temporary measure. - Reserve IV use in eclampsia for life-threatening situations. - Observe the 15 rights in drug administration. During - Give IM route by deep IM injection. - Monitor serum magnesium levels. - Do not give oral MgSO4 with abdominal pain, nausea, or
vomiting. - Do not administer if knee-jerk reflexes are suppressed - Monitor bowel function. After - Arrange to discontinue administration as soon as levels are within normal limits and desired clinical response is obtained. - Discontinue if diarrhea or cramping occurs. - Arrange for dietary measures, exercise and environmental control to return to normal bowel activity. - Report sweating, flushing, muscle tremors or twitching, inability to move extremities. - Maintain urine output at a level of 100 mL every 4 hr during parenteral administration.

Drug Half Life Unknown