From the FDA Drug Label
In counteracting the muscle-stimulating effects of barium poisoning, the usual dose of magnesium sulfate is 1 to 2 g given IV. The antidote for barium poisoning is magnesium sulfate, which can be administered intravenously in a dose of 1 to 2 g. 1
From the Research
Treatment for barium poisoning requires immediate medical attention, with a focus on supportive care, prevention of barium absorption, and correction of hypokalemia, as evidenced by the most recent study 2. The primary goal is to manage the patient's symptoms and prevent further complications.
- Administration of soluble sulfates, such as sodium sulfate, is crucial to bind with barium and form insoluble barium sulfate that cannot be absorbed by the body.
- Potassium supplementation is essential to counteract the potassium-depleting effects of barium, with doses typically ranging from 40-80 mEq IV depending on serum levels 2.
- Hemodialysis or continuous veno-venous hemodialysis filtration (CVVHDF) may be necessary to filter barium from the bloodstream in severe cases, as seen in a case report 3.
- Antiarrhythmic medications and cardiorespiratory support may also be required to manage cardiac arrhythmias and respiratory failure.
- Gastric lavage or activated charcoal might be used if the poisoning was recent, but their effectiveness is not well established.
- Continuous cardiac monitoring is essential, as barium can cause dangerous heart rhythm disturbances, including ventricular arrhythmias and cardiac arrest 4, 5, 6. The effectiveness of treatment depends largely on how quickly it begins after exposure, as barium can rapidly cause life-threatening complications, including respiratory failure and cardiac arrest 2.