What is the Magpie trial magnesium sulphate protocol?

Loading: 4g IV over 5-15 min (4g in 20 mL 20% MgSO4 solution); maintenance: 1 g/hour IV infusion; in severe pre-eclampsia, loading dose can be increased to 6g; continue for 24 hours after delivery or last seizure (whichever is later).

What magnesium levels indicate toxicity?

Therapeutic: 2-3.5 mmol/L; loss of patellar reflex: 3.5-5 mmol/L; respiratory depression: 5-6.5 mmol/L; cardiac arrest: >7.5 mmol/L; check patellar reflexes and RR hourly during infusion; stop if reflexes absent or RR <12/min.

What is the antidote for magnesium toxicity?

Calcium gluconate 1g IV (10 mL of 10% solution) slowly over 3 minutes; reverses magnesium toxicity at neuromuscular junction; have calcium gluconate at bedside throughout magnesium infusion; oxygen and airway support for respiratory depression.

How should magnesium be adjusted in renal impairment?

Magnesium is renally excreted; reduce maintenance to 0.5-1 g/hour in oliguria (<25 mL/hour); check serum magnesium every 4 hours; very close toxicity monitoring required in AKI; some protocols omit maintenance infusion in severe AKI relying on loading dose effect.

What is the diazepam alternative to magnesium for eclampsia seizure treatment?

Magnesium is superior to diazepam and phenytoin for eclampsia seizure treatment and prevention (Magpie, Collaborative Eclampsia Trial); diazepam 10 mg IV used for breakthrough seizures while establishing magnesium infusion; phenytoin not recommended for eclampsia.

Eclampsia Magnesium Sulphate Dosing and Toxicity Monitor

Calculates magnesium sulphate loading dose (4-6g IV) and maintenance infusion (1-2g/hour) for eclampsia seizure prophylaxis and treatment, with toxicity thresholds and calcium gluconate antidote dosing.

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Eclampsia Magnesium Sulphate Dosing and Toxicity Monitor

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Frequently Asked Questions

What is the Magpie trial magnesium sulphate protocol?

What magnesium levels indicate toxicity?

What is the antidote for magnesium toxicity?

How should magnesium be adjusted in renal impairment?

What is the diazepam alternative to magnesium for eclampsia seizure treatment?