RESURRECTION UNIVERSITY MEDICATION CARD

CLASSIFICATION

Mineral, electrolyte supplement

DRUG NAME

Magnesium sulfate

MECHANISM OF ACTION

Activates enzymes, carries functional role in neurotransmission and muscular excitability.

THERAPEUTIC USE

Seizure control.

CONTRAINDICATIONS

Avoid using for more than 5– 7 days for preterm labor (may increase risk of hypocalcemia
and bone changes in newborn).
Avoid continuous use during active labor or within 2 hr of delivery due to potential for
magnesium toxicity in newborn.

DOSAGES AND ROUTES

Availability: Injection: 500 mg/mL (50%). Premixed infusion: 1 g/100 mL, 2 g/100 mL, 4
g/50 mL, 4 g/100 mL, 20 g/ 500 mL, 40 g/1000 ml.

IV, IM (Adults): 4– 5 g by IV infusion, concurrently with up to 5 g IM in each buttock;

then 4– 5 g IM q4h or 4 g by IV infusion followed by 1– 2 g/h continuous infusion
Do not to exceed 40 g/day or 20 g/48 h in the presence of severe renal insufficiency.

ADVERSE EFFECTS

CNS: drowsiness.
Resp: decrease respiratory rate.
CV: arrhythmias, bradycardia, hypotension.
GI: diarrhea.
MS: muscle weakness.
Derm: flushing, sweating.
Metabolism: hypothermia

INTERACTIONS

May potentiate calcium channel blockers and neuromuscular blocking agents.

Decrease absorption of tetracyclines, fluoroquinolones, nitrofurantoin.

NURSING CONSIDERATIONS
RESURRECTION UNIVERSITY MEDICATION CARD

ASSESSMENT

Monitor pulse, BP, respirations, and ECG frequently throughout administration of

parenteral magnesium sulfate.
Respirations should be at least 16/min before each dose.
Monitor neurologic status before and throughout therapy.

PATIENT PROBLEM

Eclampsia/Pre-Eclampsia

IMPLEMENTATION

Initiate seizure precautions, B/P, ECG (magnesium sulfate); magnesium toxicity: thirst,
confusion, decrease in reflexes; I&O ratio; check for decrease in urinary output.
Patellar reflex (knee jerk) should be tested before each parenteral dose of magnesium
sulfate. If response is absent, no additional doses should be administered until positive
response is obtained

PATIENT/FAMILY EDUCATION

Explain purpose of medication to patient and family.

Educate patient and family to notify MD when experiencing signs and symptoms including
adverse effects of magnesium sulfate.

EVALUATION

Absence of seizures (eclampsia)