Management of Magnesium Administration

Description

• Clear, colourless solution 49.3%, (493mg/ml in 5 ml ampoules).

Slow IV infusion

Individual doses are charted on stat page of drug chart giving.

• amount of drug to be added.
• base fluid type and volume.
• mg/kg/dose.
• time to be infused.
• total amount to be infused.

Charted on fluid chart giving:

• rate in ml/hour
• dose in mg/kg/hour

Also charted on drug chart under continuous infusions giving:

• amount of drug to be added
• base fluid type and volume
• mg/kg/ml

Administration

Continuous Infusion

1. Administered by a nurse with Neonatal IV Drug Certification.
2. Dilute prior to use to make an 8% concentration in D5W (80 mg/ml).
   1. Draw up 8ml of 49.3% magnesium sulphate
   2. Add to 42ml D5W
   3. 50ml = 4000 mg in 50ml
                = 80 mg in 1ml
3. Filter prior to administration through a 5 micron filter.
4. Compatible with NS, D5W.
   Incompatible with calcium and sodium bicarbonate.
5. Do NOT mix with other drugs, IV solutions, blood or blood products. Use a separate line for administration of magnesium sulphate.
6. Administer via a syringe pump.
7. Change fluid and tubing every 24 hours.

Observation and Documentation

1. Monitor for adverse reactions.
2. Monitor blood pressure frequently. (Continuously if possible).
3. Continuous cardiorespiratory monitoring.
4. Document vital signs hourly and PRN.
5. Monitor fluid balance.
6. Observe for and document seizure activity.
7. Have resuscitation equipment and ventilatory support available.

Storage

• Unopened - store at room temperature <25°C.
• Discard ampoule after opening.
• Do NOT refrigerate.
• Continuous Infusion:  Diluted solution stable at room temperature for 24 hours.

Selected References