Restocking the mineral stores
Restocking the mineral stores
Magnesium is typically replaced in the form of magnesium sulfate when administered I.V. or in the form of magnesium oxide if given orally.
Pharmacokinetics
Magnesium sulfate is distributed widely throughout the body. I.V. magnesium sulfate acts immediately, whereas the drug acts within 30 minutes after I.M. administration. However, I.M. injections can be painful, can induce sclerosis, and need to be repeated frequently.
Metabolism and excretion
Magnesium sulfate isn’t metabolized and is excreted unchanged in urine and stool; some appears in breast milk.
Pharmacodynamics
Magnesium sulfate replenishes and prevents magnesium deficiencies. It also prevents or controls seizures by blocking neuromuscular transmission.
Pharmacotherapeutics
I.V. magnesium sulfate is the drug of choice for replacement therapy in symptomatic magnesium deficiency (hypomagnesemia). It’s widely used to treat or prevent preeclamptic and eclamptic seizure activity and is used to treat ventricular arrhythmias such as torsades de pointes. It’s also used to treat seizures, severe toxe-mia, and acute nephritis in children.
Drug interactions
Magnesium has few significant interactions with other drugs.
- Magnesium used with digoxin may lead to heart block.
- Magnesium sulfate combined with alcohol, narcotics, antianxiety drugs, barbiturates, antidepressants, hypnotics, antipsychotic drugs, or general anesthetics may increase central nervous system depressant effects
- Magnesium sulfate combined with succinylcholine or tubocurarine potentiates and prolongs the neuromuscular blocking action of these drugs.
Adverse reactions to magnesium
Adverse reactions to magnesium sulfate, which can be life-threatening, include:
- hypotension
- circulatory collapse
- flushing
- depressed reflexes
- respiratory paralysis
- cardiac arrest.
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