Names and pronunciation
(9.9% mg, 8.1 mEq mg/g)
Source page 824
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Individual generic drug information
Extracted information for magnesium sulfate only.
(9.9% mg, 8.1 mEq mg/g)
Source page 824
Func. class.: Electrolyte; anticonvul- sant; saline laxative, antacid
Source page 824
ACTION: Increases osmotic pressure, draws fluid into colon, neutralizes HCl
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USES: Constipation, dyspepsia; bowel preparation before surgery or exam; anticonvulsant for preeclampsia, eclamp- sia (magnesium sulfate); electrolyte; car- diac glycoside–induced arrhythmias, nutritional supplement
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Extracted information for magnesium sulfate only.
CONTRAINDICATIONS: Hyper- sensitivity, abdominal pain, nausea/vom- iting, obstruction, acute surgical abdo- men, rectal bleeding, heart block, myocardial damage Precautions: Pregnancy (magnesium sulfate), renal/cardiac disease
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SIDE EFFECTS CNS: Muscle weakness, flushing, sweat- ing, confusion, sedation, depressed reflexes, flaccid paralysis, hypothermia CV: Hypotension, heart block, circulatory collapse, vasodilation GI: Nausea, vomiting, anorexia, cramps, diarrhea HEMA: Prolonged bleeding time META: Electrolyte, fluid imbalances RESP: Respiratory depression/paralysis
Source page 826
INTERACTIONS Increase: effect of neuromuscular blockers Increase: hypotension—antihyperten- sives, calcium channel blockers Decrease: absorption of tetracyclines, fluoroquinolones, nitrofurantoin Decrease: effect of digoxin
Source page 826
Extracted information for magnesium sulfate only.
DOSAGE AND ROUTES Laxative • Adult: PO (milk of magnesia) 15-60 mL at bedtime • Adult/child >12 yr: PO (magnesium sulfate) 15 g in 8 oz water; PO (con- centrated milk of magnesia) 5-30 mL; PO (magnesium citrate) 5-10 oz at bedtime • Child 2-6 yr: PO (milk of magnesia) 5-15 mL/day Prevention of magnesium deficiency (mg of magnesium) • Adult/child ≥10 yr: PO (male) 350- 400 mg/day; (female) 280-300 mg/day; (breastfeeding) 335-350 mg/day; (preg- nancy) 320 mg/day • Child 8-10 yr: PO 170 mg/day • Child 4-7 yr: PO 120 mg/day Magnesium sulfate deficiency (mg of magnesium) • Adult: PO 200-400 mg in divided doses tid-qid; IM 1 g q6hr × 4 doses; IV 5 g (severe) • Child 6-12 yr: PO 3-6 mg/kg/day in divided doses tid-qid Preeclampsia/eclampsia (magnesium sulfate) • Adult: IM/IV 4-5 g IV infusion; with 5 g IM in each gluteus, then 5 g q4hr or 4 g IV INFUSION, then 1-3 g/hr CONT IN- FUSION, max 30-40 g/24 hr or 20 g/48 hr in severe renal disease
Source page 824
Available forms: Chloride: sus rel tabs 535 mg (64 mg Mg); enteric tabs 833 mg (100 mg Mg); citrate: oral sol 240-, 296-, 300-mL bottles (77 mEq/100 mL); gluconate: tabs 500 mg; liquid 54 mg/5 mL; oxide: tabs 400 mg; caps 140 mg; hydroxide: liq 400 mg/5 mL; concentra- tion liq 800 mg/5 mL; chew tabs 300, 600 mg; sulfate: 500 mg/mL; premixed infu- sion 1 g/100 mL, 2 g/100 mL, 4 g/50 mL, 4 g/100 mL, 20 g/500 mL, 40 g/1000 mL
Source pages 824, 825
Administer: PO route • With 8 oz water • Refrigerate magnesium citrate before giving • Shake susp before using as antacid at least 2 hr after meals • Tablets should be chewed thoroughly before patient swallows; give 4 oz of wa- ter afterward • Laxative: give on empty stomach with full glass of liquid, do not give at bedtime IM route (magnesium sulfate) • Give deeply in gluteal site IV route (magnesium sulfate) • Only when calcium gluconate is avail- able for magnesium toxicity Direct IV route • Dilute 50% sol to ≤20%, give at ≤150 mg/min Continuous IV INFUSION route • May dilute to 20% sol, infuse over 3 hr • IV at less than 125 mg/kg/hr; circulatory collapse may occur; use INFUSION pump Y-site compatibilities: Acyclovir, aldes- leukin, alemtuzumab, alfentanil, amifos- tine, amikacin, aminocaproic acid, arg- atroban, arsenic trioxide, ascorbic acid injection, asparaginase, atenolol, atosi- ban, atracurium, atropine, azithromycin, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorphanol, calcium gluconate, cangre- lor, CARBOplatin, carmustine, caspofun- gin, cefotaxime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cephapirin, chloramphenicol, chlorproMAZINE, cimetidine, cisatracurium, CISplatin, clindamycin, cloNIDine, codeine, cyano- cobalamin, cyclophosphamide, cytara- bine, DACTINomycin, DAPTOmycin, DAUNOrubicin liposome, DAUNOrubicin, dexmedetomidine, dexrazoxane, digoxin, diltiaZEM, dimenhyDRINATE, diphen- hydrAMINE, DOBUTamine, DOCEtaxel, dolasetron, DOPamine, doripenem, dox- acurium chloride, DOXOrubicin liposomal, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, epoetin alfa, eptifibatide, ertapenem, esmolol, etopo- side, etoposide phosphate, famotidine, fenoldopam, fentaNYL, fluconazole, fludarabine, fluorouracil, folic acid (as sodium salt), foscarnet, gallium, gati- floxacin, gemcitabine, gemtuzumab, gen- tamicin, glycopyrrolate, granisetron, heparin, HYDROmorphone, hydrOXY- zine, IDArubicin, ifosfamide, imipenem- cilastatin, insulin (regular), irinotecan, isoproterenol, kanamycin, ketamine, ketorolac, labetalol, lactated Ringer’s injection, lepirudin, leucovorin, lido- caine, linezolid, LORazepam, mannitol, mechlorethamine, mesna, metaraminol, methotrexate, methyldopate, metoclo- pramide, metoprolol, metroNIDAZOLE, micafungin, midazolam, milrinone, minocycline, mitoMYcin, mitoXANTRONE, mivacurium, morphine, moxifloxacin, M multiple vitamins injection, mycopheno- late mofetil, nafcillin, nalbuphine, nesiritide, netilmicin, niCARdipine, nitro- glycerin, nitroprusside, norepinephrine, octreotide, ondansetron, oxaliplatin, oxy- tocin, PACLitaxel, palonosetron, pami- dronate, pancuronium, papaverine, PEMEtrexed, penicillin G potassium/ sodium, pentazocine, PENTobarbital, PHENobarbital, phentolamine, phenyl- ephrine, piperacillin, piperacillin tazo- bactam, polymyxin B, potassium acetate/ chloride, procainamide, prochlorpera- zine, promethazine, propranolol, prot- amine, pyridoxine, quiNIDine, quinupris- tin-dalfopristin, raNITIdine, remifentanil, Ringer’s injection, riTUXimab, rocu ronium, sargramostim, sodium acetate/ bicarbonate, succinylcholine, SUFentanil, tacrolimus, telavancin, teniposide, theophylline, thiamine, thiotepa, ticarcil- lin, ticarcillin-clavulanate, tigecycline, tirofiban, TNA (3-in-1), tobramycin, tolazoline, topotecan, TPN (2-in-1), trastuzumab, urokinase, vancomycin, vasopressin, vecuronium, verapamil, vinBLAStine, vinCRIStine, vinorelbine, vitamin B complex with C, voriconazole, zoledronic acid
Source page 825
Extracted information for magnesium sulfate only.
Assess: • Laxative: cause of constipation; lack of fluids, bulk, exercise; cramping, rectal bleeding, nausea, vomiting; product should be discontinued • Eclampsia: seizure precautions, B/P, ECG (magnesium sulfate); magnesium toxicity: thirst, confusion, decrease in reflexes; I&O ratio; check for decrease in urinary output • Pregnancy/breastfeeding: use only if clearly needed (chloride), contrain dicated in labor, toxemia during 2 hr prior to delivery, appears in breast milk
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Evaluate: • Therapeutic response: decreased con- stipation, absence of seizures (eclamp- sia), normal serum calcium levels
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • Not to use laxatives for long-term ther- apy because bowel tone will be lost • That chilling improves taste of magne- sium citrate • To shake suspension well • Not to give at bedtime as a laxative, may interfere with sleep; that milk of magnesia is usually given at bedtime • To give citrus fruit after administering to counteract unpleasant taste • About reason for product, expected results
Source page 826
Extracted information for magnesium sulfate only.
PHARMACOKINETICS PO: Onset 1-2 hr IM: Onset 1 hr, duration 4 hr IV: Duration ½ hr Excreted by kidney, effective anticonvul- sant serum levels 2.5-7.5 mEq/L
Source page 826
Filter the extracted dose blocks for this individual drug.
Laxative
• Adult: PO (milk of magnesia) 15-60 mL at bedtime
Candidate age grouping · source page 824
Laxative
• Adult/child >12 yr: PO (magnesium sulfate) 15 g in 8 oz water; PO (con- centrated milk of magnesia) 5-30 mL; PO (magnesium citrate) 5-10 oz at bedtime
Candidate age grouping · source page 824
Laxative
• Child 2-6 yr: PO (milk of magnesia) 5-15 mL/day Prevention of magnesium deficiency (mg of magnesium)
Candidate age grouping · source page 824
Laxative
• Adult/child ≥10 yr: PO (male) 350- 400 mg/day; (female) 280-300 mg/day; (breastfeeding) 335-350 mg/day; (preg- nancy) 320 mg/day
Candidate age grouping · source page 824
Laxative
• Child 8-10 yr: PO 170 mg/day
Candidate age grouping · source page 824
Laxative
• Child 4-7 yr: PO 120 mg/day Magnesium sulfate deficiency (mg of magnesium)
Candidate age grouping · source page 824
Laxative
• Adult: PO 200-400 mg in divided doses tid-qid; IM 1 g q6hr × 4 doses; IV 5 g (severe)
Candidate age grouping · source page 824
Laxative
• Child 6-12 yr: PO 3-6 mg/kg/day in divided doses tid-qid Preeclampsia/eclampsia (magnesium sulfate)
Candidate age grouping · source page 824
Laxative
• Adult: IM/IV 4-5 g IV infusion; with 5 g IM in each gluteus, then 5 g q4hr or 4 g IV INFUSION, then 1-3 g/hr CONT IN- FUSION, max 30-40 g/24 hr or 20 g/48 hr in severe renal disease
Candidate age grouping · source page 824