ACLS Pharmacology – Magnesium Sulfate

Magnesium Sulfate is a chemical compound that contains sulfur, oxygen and magnesium. It has been used for years for medical purposes such as in forms of magnesium hydroxides and oxides in antacids, and magnesium salicylates for analgesics. Also magnesium salts are used for constipation. Magnesium Sulfate is also used in advanced cardiac life support as a intravenous IV push or infusion. This medication is classified as an antidysrhythmia and works to reverse the effects of hypomagnesaemia that is seen after a myocardial infarction. It works to stabilize the tissue membranes.

Magnesium Sulfate has become a protocol in prehosptial care for certain types of cardiac arrhythmias, insufficiencies and cardiac death that is sudden for some patients. Magnesium deficiency is often associated with these emergency cardiac conditions. This medication is used to treat torsade de pointes, refractory VF/VT, class I torsade 8 and 11 and class IIa refractory VF/FT. Although this treatment choice is far down on the emergency protocol for prehospital treatment for VF/VT, it is not a commonly used treatment choice except when torsade is recognized early.

Torsades de pointes can be caused by a number of different causes. Some of these include diarrhea, malnutrition, alcoholism, drug interactions, dietary supplements, and certain medications like methadone, antidepressants, lithium among others. This emergency condition can also be caused by a side effect from certain anti-arrhythmias such as quinidine and sotalol. It can also be brought on by hypokalemia or hypomagnesaemia. This cardiac emergency condition may be seen with an EKG reading that is distinguishable when torsade is present.

Patients in hospital settings are sometimes given Magnesium sulfate for acute Myocardial Infarction when magnesium deficiency is known as a contributing factor to the MI. If paramedics are clearly aware that the patient is suffering from malnutrition or uses diuretics or have misused them, they can relay this information to their on-line medical control unit and Magnesium Sulfate may be ordered for administration.

Side effects associated with this medication are rare but could include drowsiness, hypotension, and circulatory collapse, absent or lowered deep tendon reflexes, diaphoresis and respiratory depression. Magnesium Sulfate is normally well tolerated.