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# Magnesium Sulfate
## Overview
Magnesium sulfate is an electrolyte that plays a crucial role in numerous cellular functions. It is available for intravenous (IV) and intramuscular (IM) administration.
## Primary Indications
* Treatment of hypomagnesemia.
* Prevention and treatment of seizures in preeclampsia and eclampsia.
* Management of status epilepticus refractory to other agents.
* Treatment of torsades de pointes.
* Bronchodilator in severe asthma exacerbations (less common, often reserved for refractory cases).
## Adult Dosing
* **Hypomagnesemia:**
* Severe deficiency: 4-6 g (32-48 mEq) IV infused over 10-60 minutes, followed by 1-2 g (8-16 mEq) per hour as a continuous infusion.
* Milder deficiency: 1-2 g (8-16 mEq) IV or IM every 4-6 hours for 3-4 doses.
* IM: 1 g (8 mEq) injected deeply every 4-6 hours for 4 doses. Maximum IM dose is typically 2 g (16 mEq) per site.
* **Preeclampsia/Eclampsia:**
* Loading dose: 4-6 g (32-48 mEq) IV infused over 5-20 minutes.
* Maintenance infusion: 1-2 g (8-16 mEq) per hour. Dosing may be adjusted based on seizure activity and magnesium levels.
* IM alternative: 5 g (40 mEq) IM in each buttock (total 10 g) for the initial dose, followed by 5 g (40 mEq) IM every 4 hours.
* **Torsades de Pointes:** 1-2 g (8-16 mEq) IV in 10 mL of D5W over 5-10 minutes. May be followed by an infusion of 0.5-1 g/hour.
* **Status Epilepticus (refractory):** 2-4 g (16-32 mEq) IV over 30 minutes.
Dosing can vary significantly based on institutional protocols and patient response.
## Pediatric Dosing
Dosing in pediatric patients is weight-based and should be guided by expert consultation or institutional protocols.
* **Hypomagnesemia:**
