Mag sulfate piggyback?

[fiveoclocksomewhere]

If a pt is receiving NS with potassium added, could you piggyback mag sulfate on it? Might be a dumb question but I can't find any answers after searching the net :/ if not, how would you give the mag? Still a newbie so bear with me lol.

[Esme12, ASN, BSN, RN]

I suggest you check your policy or your pharmacy to see if there is a concurrent policy. They are comparable and stable as they are common additives in the same TPN bag. Check with your charge nurse to be sure. Some facilities have policy on whether the pateint needs to be on a heart monitor be sure to infuse it on its own tubing and slowly as it can cause severe hypotension.

MAGNESIUM SULFATE -Â* Intravenous (IV) Dilution

Incompatibilities

Magnesium sulfate in solution may result in a precipitate formation when mixed with solutions containing:

[TABLE]

[TR=class: First]

[TD]Alcohol (in high[/TD]

[TD]Heavy Metals[/TD]

[/TR]

[TR]

[TD] concentrations)[/TD]

[TD]Hydrocortisone sodium[/TD]

[/TR]

[TR]

[TD]Alkali carbonates and[/TD]

[TD] succinate[/TD]

[/TR]

[TR]

[TD] bicarbonates[/TD]

[TD]Phosphates[/TD]

[/TR]

[TR]

[TD]Alkali hydroxides[/TD]

[TD]Polymixin B sulfate[/TD]

[/TR]

[TR]

[TD]orificenates[/TD]

[TD]Procaine hydrochloride[/TD]

[/TR]

[TR]

[TD]Barium[/TD]

[TD]Salicylates[/TD]

[/TR]

[TR]

[TD]Calcium[/TD]

[TD]Strontium[/TD]

[/TR]

[TR=class: Last]

[TD]Clindamycin phosphate[/TD]

[TD]Tartrates[/TD]

[/TR]

[/TABLE]

The potential incompatibility will often be influenced by the changes in the concentration of reactants and the pH of the solutions.

It has been reported that magnesium may reduce the antibiotic activity of streptomycin, tetracycline and tobramycin when given together.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

Solutions for intravenous infusion must be diluted to a concentration of 20% or less prior to administration. The diluents commonly used are 5% Dextrose Injection, USP and 0.9% Sodium Chloride Injection, USP. Deep intramuscular injection of the undiluted (50%) solution is appropriate for adults, but the solution should be diluted to a 20% or less concentration prior to such injection in children.

In Magnesium Deficiency

In the treatment of mild magnesium deficiency, the usual adult dose is 1 g, equivalent to 8.12 mEq of magnesium (2 mL of the 50% solution) injected intramuscularly every six hours for four doses (equivalent to a total of 32.5 mEq of magnesium per 24 hours). For severe hypomagnesemia, as much as 250 mg (approximately 2 mEq) per kg of body weight (0.5 mL of the 50% solution) may be given intramuscularly within a period of four hours if necessary. Alternatively, 5 g, (approximately 40 mEq) can be added to one liter of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP for slow intravenous infusion over a three-hour period. In the treatment of deficiency states, caution must be observed to prevent exceeding the renal excretory capacity.

[Esme12, ASN, BSN, RN]

PLease check with a senior staff member or call your house supervisor.

[PediLove2147, BSN, RN]

Hope so, I run it as a piggyback all the time! In all seriousness though, I agree with PP, check your policy.