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# Magnesium Sulfate ## Overview An essential mineral involved in numerous enzymatic and physiological processes, including neuromuscular function, cardiac rhythm, and protein synthesis. ## Primary Indications * Hypomagnesemia * Torsades de Pointes * Eclampsia and pre-eclampsia * Bronchodilation (off-label, typically inhaled) * Constipation (oral, considered a saline laxative) ## Adult Dosing * **Hypomagnesemia:** * **Severe (serum Mg < 1.5 mg/dL):** 4-6 grams IV initially, followed by 2-4 grams IV every 4-12 hours based on serum magnesium levels and clinical response. * **Mild/Moderate (serum Mg 1.5-2.5 mg/dL):** 2-4 grams IV, followed by 1-2 grams IV every 4-12 hours. * **IM injection:** 1 gram IM every 4-6 hours for 4 doses. * **Oral:** 2.5-5 grams PO daily in divided doses. * **Torsades de Pointes:** 1-2 grams IV in 10-15 mL D5W over 5-10 minutes. May repeat once, then infusion of 0.5-1 gram/hour. * **Eclampsia/Pre-eclampsia:** Loading dose of 4-6 grams IV infused over 5-10 minutes, followed by a maintenance infusion of 1-2 grams/hour. Local protocol often dictates specific regimens. * **Bronchodilation (Inhaled):** 1.5-3 grams diluted in 100 mL normal saline via nebulizer over 15-30 minutes. Use is typically reserved for severe cases refractory to standard bronchodilators. ## Pediatric Dosing * **Hypomagnesemia:** Dosing is complex and typically based on ideal body weight, serum magnesium levels, and renal function. Specific protocols should be consulted. Generally, IV doses range from 25-75 mg/kg per dose, given over 1-2 hours, with