Magnesium Sulfate

Dilution guide

Indication

Eclampsia, torsades, severe asthma, hypomagnesaemia.

Preparation

Eclampsia: 4 g in 100 mL NS over 20 min, then 1 g/h infusion.

Dilution

20 g in 500 mL NS (40 mg/mL) for infusion.

Rate

Eclampsia 1–2 g/h. Torsades 2 g IV over 10 min. Asthma 2 g over 20 min.

Monitoring

  • Patellar reflexes
  • RR (hold if <12)
  • Urine output
  • Mg level (target 4–7 mEq/L in eclampsia)

Common errors

  • Overdose → respiratory depression — treat with 1 g Ca gluconate IV

Pearls

  • Loss of patellar reflex is first sign of toxicity
WardRound

WardRound

Clinical Decisions in Seconds