Magnesium Sulfate

Treatment of hypomagnesemia and magnesium deficiency in critically ill pts

Treatment of torsade de pointes, atrial or ventricular arrhythmias, digoxin toxicity

Prevention of seizures due to preeclampsia/eclampsia

Decrease risk of cerebral palsy in the early preterm fetus

Management of conditions with catecholamine excess (tetanus, pheochromocytoma, attenuation of stress response during laryngoscopy)

Orally as cathartic or laxative

Treatment of acute severe asthma exacerbation not responding to conventional approaches

Adjuvant to other agents during general anesthesia to reduce the requirements of analgesics, muscle relaxants, and hypnotics

Treatment of refractory hypokalemia

Hypotension via decrease in SVR, worse with rapid administration.

Muscle weakness in pts with high levels of serum magnesium (>8 mEq/L ⁻¹ ).

Inadvertent use in pts with impaired renal function can lead to a state of hypermagnesemia.

Potentiation of nondepolarizing NMBs. NMB dose adjustment and monitoring train of four is necessary. Adverse effects on neuromuscular function may occur at lower concentrations in pts with neuromuscular disease (e.g., myasthenia gravis).

Magnesium deficiency is highly undesirable in the periop period and in critical care owing to the increased risk of arrhythmias.

Decreased responsiveness to vasopressors due to effect of magnesium on catecholamine reuptake and hypotension due to decreased SVR.