What rate should you IVP MgSO4?

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Hello,

I am studying dysrhythmias. I haven't done IVP, hanged IV bags, IVPB in so long. I am in 4th and last I did anything in SIM or clinical was in second semester. I definitely need a refresher.

I get so confused when reading a drug book for when doing IVP or IV rates, etc.

For example, for Torsades De Points, if the cause is hypomagnesium, give Magnesium Sulfate 1-2g and D5W over 5-20min.

So, this is how I calculated it for an IVP (if thats whats ordered, I'm assuming it'd be ordered as an IVP):

1g/5min = 0.2mg/min

or if needed more, 2g/5min= 0.4mg/min

How would you know if its best to do it over 5min or 20min?

Maybe I misinterpreted it, and it meant 1-2g IVP and D5W IV over 5-20min?

I don't know if they come in a vial, and if they do, idk the typical volume in the vial. My drug Guide says the rate is to be administered no greater than 150mg/min.

But if I am doing IVP, I am trying to get an idea of what the vial would typically have mg/mL.

I am so confused and I know this is so basic. I feel embarrassed!

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Specializes in SICU, trauma, neuro.

It comes in vials of 1g/2ml. For run of the mill hypomagnesemia -- say, an a.m. lab comes back low -- I've always diluted it in 50 ml NS and give it as a piggyback over one hour. Now with Torsades, that pt is coding -- in effect, dead. In that case, you want to push it. (Dilated to 10 ml with NS) Given that the pt is virtually dead, I would stick with the short end of the range, so in the case of MgSO4 I would push it over 5 min, vs 20 min.

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1g/5min = 0.2mg/min

or if needed more, 2g/5min= 0.4mg/min

My drug Guide says the rate is to be administered no greater than 150mg/min.

But if I am doing IVP, I am trying to get an idea of what the vial would typically have mg/mL.

I am so confused and I know this is so basic. I feel embarrassed!

Don't be embarrassed.

Maybe part of the reason this is not making sense compared to what your drug guide states is that you've made an error with your units of measurement, above.

1g/5 minutes is the same as 1,000mg/5 min, which means **200** mg per minute. Not 0.2 mg. Right? If you give 0.2 mg/min, then after 5 minutes you will have only given 1 whole mg. :)

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It comes in vials of 1g/2ml. For run of the mill hypomagnesemia -- say, an a.m. lab comes back low -- I've always diluted it in 50 ml NS and give it as a piggyback over one hour. Now with Torsades, that pt is coding -- in effect, dead. In that case, you want to push it. (Dilated to 10 ml with NS) Given that the pt is virtually dead, I would stick with the short end of the range, so in the case of MgSO4 I would push it over 5 min, vs 20 min.

When you mean dilute (10mL with NS), what do you mean? Do you mean you push 2mL (1g) of MgO4 over 5min (so 2mL/5min = 0.4mL/min for 5min) followed with 10mL of NS with a profiled syringe? Correct me if I'm wrong, please.

I'm trying to figure out how fast I should push MgO4 over the 5 minutes. I've heard students do IVP like, 02.mL per 30 seconds for 5min (just using as an example for how fast to push IVP meds).

I'm not sure if I am making any sense lol, I apologize if I am not. But thats what I am trying to figure out.

OR .. in this deadly rhythm, should I just slam it 0.4mL every minute for over 5min to get it in fast?

Also, my teacher stated this in her lecture: 1-2g and D5W over 5-20min". this is why I am confused. How would I give this to the patient with Torsades? Do I give 1g/2mL (0.4mL every min for 5min) with a D5W hanging for 5-20min? I'm so confused!

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Don't be embarrassed.

Maybe part of the reason this is not making sense compared to what your drug guide states is that you've made an error with your units of measurement, above.

1g/5 minutes is the same as 1,000mg/5 min, which means **200** mg per minute. Not 0.2 mg. Right? If you give 0.2 mg/min, then after 5 minutes you will have only given 1 whole mg. :)

thanks! I am trying to see how FAST to push it. I wasn't;t sure if they come in vials (mL). So I wanted to see how much I'd draw (another user stated they would do it over 5min since this IS a deadly rhythm).

So, if MgSO4 comes in a 1g/2mL vial, and want to start off with 1g over 5min, I'd pull up 2mL and give it over 5min ... so 2mL/5min = 0.4mL/min for 5min .. correct me if I'm wrong please!

OR .. should I slam the MgSO4 since this is a deadly rhythm? I'm trying to figure out how fast to inject it. I remember having an IVP med in medsurg in second semester where I had to tell the SIM instructor how fast I am to push it. It was something like, "0.5mL every 30 seconds, for ___ minutes". That's what I am trying to figure out for this particular situation I posted.

I don't know if I make sense and I apologize if I don't. But I ALWAYS got confused on how fast to push IVP meds! lol

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Specializes in SICU, trauma, neuro.

To push, I waste 2 ml from a prefilled NS syringe, and then draw up the 2 ml of MgSO4. (Or if the ordered dose is 2 gm, you would waste 4 ml of the NS, and draw up two of the MgSO4 vials.) Then having 10 ml, if you push one ml every 30 seconds, that will amount to the whole dose being given over 5 min. Hope that makes sense! :)

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To push, I waste 2 ml from a prefilled NS syringe, and then draw up the 2 ml of MgSO4. (Or if the ordered dose is 2 gm, you would waste 4 ml of the NS, and draw up two of the MgSO4 vials.) Then having 10 ml, if you push one ml every 30 seconds, that will amount to the whole dose being given over 5 min. Hope that makes sense! :)

DEFINITELY makes sense. Thank you SO much! Since my teacher said 1-2g and D5W over 5-20min, does that mean I just give the 1-2g with the NS like you said, and then the D5W, I would run THAT over 20min? That's what I am confused about now. I understand the rate you provided just now about the MgSO4

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UpToDate recommends administering over 1-2 min in pulseless cardiac arrest, and over 15 min for other situations such as non-sustained torsades.

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