From the Research
The recommended dose of magnesium sulfate for pediatric patients is 25-50 mg/kg/dose (maximum 2 grams) given intravenously over 20 minutes for severe asthma exacerbations, with a maximum dose of 27 mg/kg to avoid escalation in therapy. This dose is based on the most recent and highest quality study available, which found that doses above 27 mg/kg were associated with an increased need for invasive or non-invasive mechanical ventilation or need for adjunctive therapy 1. For other indications, such as seizures or eclampsia in adolescents, the loading dose is typically 4-6 grams IV over 15-20 minutes, followed by a maintenance infusion of 1-2 grams per hour. Some key points to consider when administering magnesium sulfate to pediatric patients include:
- Monitoring vital signs, deep tendon reflexes, and respiratory status during administration
- Checking magnesium levels periodically, especially with repeated dosing
- Having calcium gluconate available as an antidote in case of toxicity
- Using weight-based dosing to minimize the risk of adverse effects
- Being aware of the potential for escalation in therapy with higher doses, as found in the study by 1 Other studies, such as 2, 3, 4, and 5, provide additional information on the use of magnesium sulfate in pediatric patients, but the most recent and highest quality study 1 provides the best guidance on dosing.