황산마그네슘 (엡솜염)

투여 경로

금기

• Renal failure or severe renal impairment
• Heart block or significant myocardial damage
• Myasthenia gravis (can exacerbate weakness)
• Heart block
• Myocardial damage
• Renal impairment
• Renal failure

이상반응

• Hypermagnesemia
• Muscle weakness
• Respiratory depression
• Hypotension
• Cardiac arrhythmias or heart block
• Diarrhea (with oral administration)
• Somnolence
• CNS depression
• Coma
• Muscular weakness
• Bradycardia
• Prolonged Q-T intervals
• Neuromuscular blockade
• Cardiac arrest

약물 상호작용

• Neuromuscular blocking agents · Potentiates neuromuscular blockade
• CNS depressants · Additive CNS depression
• Calcium channel blockers · Risk of profound hypotension and cardiovascular collapse
• Barbiturates · Additive CNS depression effects · moderate
• General anaesthetics · Additive CNS depression effects · moderate
• Non-depolarizing neuromuscular blocking agents · Risk of severe neuromuscular blockage · major
• Digitalis glycosides · Serious conduction disturbances can occur · major

모니터링

• Serum magnesium concentrations
• Electrocardiogram (ECG)
• Respiratory rate and depth
• Deep tendon reflexes (e.g., patellar reflex)
• Renal function (BUN, creatinine)
• Blood pressure
• Serum magnesium levels
• ECG (for Q-T interval and heart rate)
• Respiratory rate and effort
• Renal function

과용량

Signs of **hypermagnesemia** (magnesium toxicity) include loss of deep tendon reflexes, severe muscle weakness, hypotension, respiratory depression, heart block, and potentially cardiac arrest. > **Treatment:** Discontinue administration immediately. Administer **intravenous calcium** (e.g., calcium gluconate 10%) slowly to antagonize the cardiovascular and neuromuscular effects. Provide respiratory support (intubation and ventilation) and fluid therapy as needed.