ACLS Medications Review: Magnesium

Reviewing the primary uses, dosage, and anything else you need to know about the administration of magnesium sulfate to treat cardiac arrest.


Magnesium sulfate is an ACLS drug that can be found in the Adult Cardiac Arrest Algorithm. Magnesium is a second line antiarrhythmic drug that is used when torsades de pointes (polymorphic VT) are present. You should also consider administering magnesium when you suspect the patient is experiencing hypomagnesemia or a magnesium deficiency.


Signs of hypomagnesemia are often seen in patients who are alcoholics or have other issues with malnutrition.


Lastly, magnesium is also recommended to treat life-threatening ventricular arrhythmias due to digitalis toxicity.


ACLS Medications: Magnesium | eMedCert



When using magnesium sulfate for torsades de pointes, use a loading dose of 1-2 g IV/IO diluted in 10 mL D 5W, given over 5-20 minutes.


Follow with an infusion dose of 0.5-1 g/hour.


Additional Notes

- Rapid administration may lead to a drop in blood pressure


- Use with caution for patients with renal failure


- Very high doses can cause respiratory distress. Calcium is an antidote to reverse


- Routine administration in hospitalized patients with Acute Myocardial Infarction (AMI) is not recommended

For a brief review of all the ACLS medications you should be familiar with, check out this short video. It acts as a great visual reference that will help you study more efficiently and effectively. If you are interested in obtaining your ACLS Certification or Recertification online, click the button below in order to learn more!