Magnesium & Calcium

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Author:
cjl410
ID:
173992
Filename:
Magnesium & Calcium
Updated:
2012-09-27 21:39:56
Tags:
Phoenix College Paramedic 2012 2013 Drug Profiles Magnesium Calcium
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Phoenix College Paramedic 2012 2013 Drug Profiles - Magnesium & Calcium
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  1. Generic name for Magnesium?
    Magnesium sulfate
  2. Brand name for Magnesium?
    Magnesium sulfate
  3. Class for Magnesium?
    Electrolyte
  4. Mechanism of action for Magnesium?
    • Antagonizes calcium and blocks calcium channels causing:
    •      Bronchial smooth muscle relaxation
    •      Vasodilation
    •      CNS depressant effective in the management of seizures from eclampsia
    • Anti-arrythmic action related to maintaining intracellular K+ & blocking Ca++ channels
    • Reduces myocardial irritability secondary to hypomagnesemia
    • Reduces acetylecholine release from neurons causing:
    •      CNS depressant effective in the management of seizures from eclampsia
    •      Blocks peripheral neuromuscular transmission reducing muscle stimulation
  5. Indications and field use for Magnesium?
    • Severe bronchospasm refractory to inhaled Beta2 agonist
    • Torsade de Points
    • Refractory V-Fib/Pulseless VTach after anitarrhythmics
    • Pregnancy induced hypertension
    •      Pre-Eclampsia and/or eclampsia
    • Hypomagnesemia
  6. Dosage for Magnesium?
    All dosages diluted.  Routes: IV/IO slow push, IV fusion, IM

    Adult:

    • Severe bronchospasm refractory to inhaled Beta 2 agonist
    •      2 grams in 50 or 100cc NS bag infusion over 10 minutes

    Why?

              Antagonizes calcium and blocks calcium channels causing bronchial smooth muscle relaxation

    • Cardiac Arrest V-Fib / Pulseless V-Tach/Torsades de Points
    •      2 gram in 50 or 100cc NS bag infusion over 5 minutes

    Why?

              Antiarrhythmic action related to maintaining intracellular K+ & blocking Ca++ channels

    • Pre-eclampsia and/or eclampsia
    •      4-6 grams in 50 or 100 NS bag infusion over 20 minutes

    Why?

    •           Antagonizes calcium and blocks calcium channels causing CNS depression
    •           Reducing acetylcholine release from neurons causing CNS depression

    • Peds:
    • Cardiac arrest V-fib/Pulseless V-Tach/Torsades de Points or Torsade with pulse or severe bronchospasm refractory to inhaled Beta2 agonist
    •      25-50mg/kg up to 2.0 grams max in 50 cc NS bag infusion over 10 minutes
  7. Contraindications for Magnesium?
    • Hypermagnesemia 
    • Hypocalcemia
    • Heart blocks
    • Impaired renal function = relative
  8. Pregnancy category for Magnesium?
    A
  9. Drug intereactions for Magnesium?
    • Digitalis/Digoxin/Lanoxin use can cause dysrhythmias
    • Calcium chloride may reverse overdose
    • Anticonvulsant may still be needed in eclampsia
  10. Side effects for Magnesium?
    • Muscle weakness/paralysis
    •      Stop admin if patient loses deep tendon reflexes or has respiratory depression
    • Itching / Flushing / Burning
    • Nausea
    • Depressed cardiac function / Heart block / Asystole
    • Sweating
    • Hypotension, usually transient
    • Hypocalcemia
    • Hypermagnesemia
    • CNS depression
    • Circulatory collapse
  11. Onset of Action for Magnesium?
    • IV:  Seconds
    • IM: 1 hour
  12. Peak effect for Magnesium?
    Varies
  13. AZ Drug box supply for Magnesium?
    10 x 1 gram in 2cc vials (0.5mg/cc)
  14. Generic name for Calcium?
    Calcium Chloride 10%
  15. Brand name for Calcium?
    Caclium Chloride
  16. Class for Calcium?
    Electrolyte
  17. Mechanism of Action for Calcium?
    • Increases serum calcium ion levels
    •      Increases muscle force of contraction
    •      Increased neurotransmitter release
  18. Indications and field use for Calcium?
    • Calcium channel blocker OD
    • Pretreatment for Verapamil
    • Hyperkalemia
  19. ContraDosage for Calcium?
    All dosages are IV push

    Adult:

    • Calcium channel blocker OD, Hypocalcemia, Hyperkalemia, Hypermagnesemia
    •      Calcium Chloride 10% 0.5-1.0 gram IV push.  May repeat in 10mm
    • Pretreatment of Verapamil
    •      Calcium Chloride 10% 2-4mg/kg IV push
  20. Contraindications for Calcium?
    • Digitalis, Lanoxin, Digoxin (may cause asytole or gig toxicity)
    • Hypercalcemia
  21. Drug interaction for Calcium?
    • Digitalis, Lanoxin, Digoxin may cause asytole or gig toxicity
    • Don't give in smae IV as another drug unless line flushed well
  22. Side effects for Calcium?
    • Bradycardia
    • Asystole
    • Tissue necrosis if infiltrates
  23. Onset of action for Calcium?
    Immediate
  24. AZ drug box supply for Calcium?
    2 x 1 gram in 10 cc (10% solution) prefilled syringe

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