Table 1.
Magnesium Sulphate for Refractory Status Epilepticus
(For patients who are not responsive to standard Status Epilepticus management) | |
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Preparation available in KKH Formulary: 49.3% w/v MgSO4 (10mmol/5mL) 1ml = 2 mmol Mg2+ = 493 mg MgSO4 | |
Target serum level: 2-4 mmol/l | Endpoint: Electroencephalographic seizure control |
Dosing regimen: Loading: 50mg/kg over 30 minutes (Max = 4g/dose) Maintenance: start at 20mg/kg/hr (range 20 mg/kg/hr – 40mg/kg/hr) Maximum infusion dose: 40mg/kg/hr (Recommended maximum daily dose = 40g/day) | |
Dilution: Loading: Load 50mg/kg MgSO4 (≈ 0.1ml/kg of 49.3% w/v MgSO4) over 30 minutes (Max rate : 150mg/min) Dilute every 1 ml of 49.3% MgSO4 with 2.5 ml 0.9% NaCl | |
Maintenance (for CENTRAL LINE): Dilute 500mg Mg (=1ml 49.3% w/v MgSO4) × Body Weight with 0.9% NaCl to a total volume of 50 ml (1ml/hr = 10 mg/kg/hr) Run between 1ml/hr to 4ml/kg/hr (= 10mg/kg/hr to 40 mg/kg/hr) |