Drug Reference
Rhythm
Magnesium sulfate
Electrolyte / Ca²⁺ antagonist
IndicationAdultPediatric
Torsades (arrest)Adult1–2 g IV/IO diluted, pushPeds25–50 mg/kg (max 2 g)
Torsades with pulseAdult1–2 g IV over 5–20 minPeds-
EclampsiaAdult4–6 g IV over 15–20 min, then 1–2 g/hPeds-
Indications
- Torsades de pointes
- Hypomagnesemia
- Severe asthma
- Eclampsia
Contraindications & cautions
- Hypermagnesemia
- Myasthenia gravis (caution)
Key pearls
- Not effective for monomorphic VT or VF without torsades
- Toxicity: loss of reflexes → respiratory depression → arrest; reverse with calcium