USMLE

Magnesium

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Cardiovascular Pharm
  1. Adenosine
  2. Magnesium
  3. Nitroprusside
  4. Nitrates
  5. Ivabradine
  6. Digoxin/Digitalis
  7. Class IA Antiarrhythmics
  8. Class IB Antiarrhythmics
  9. Class IC Antiarrhythmics
  10. Class II Antiarrhythmics
  11. Class III Antiarrhythmics - Amiodarone
  12. Class III Antiarrythmics - Sotalol
  13. Class III Antiarrhythmics - Ibutilide, Dofetilide
  14. Class IV Antiarrhythmics - Verapamil, Diltiazem
  15. HMG-CoA Reductase Inhibitors (Statins)
  16. Ezetimibe
  17. Fibrates
  18. PCSK9 Inhibitors (Alirocumab, Evolocumab)
  19. Fish Oil and Omega-3s
  20. Milrinone
  21. Aliskiren
  22. Hydralazine
  23. Ranolazine
  24. Sacubitril

Summary

Magnesium is a natural calcium channel blocker that is administered intravenously as magnesium sulfate. Clinically, magnesium is used to treat preeclampsia and eclampsia in pregnant women, and also is used to treat torsades de pointes.

Key Points

  • Magnesium
    • Delivered intravenously as magnesium sulfate
    • Mechanism
      • Natural calcium channel blocker
        • Magnesium competes with calcium for same receptors on cardiac tissue
    • Clinical Use
      • Pre-eclampsia/Eclampsia
        • Prevents seizures in these patients
      • Effective in torsades de pointes
        • Blockade of calcium channels suppresses early afterdepolarizations, terminating the arrhythmia
      • May be used in digoxin toxicity
        • Adjuvant used second-line with digoxin antibodies
    • Adverse Effects