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Magnesium Citrate
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Reference Range
Test Interactions
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(mag NEE zhum SIT rate)

U.S. Brand Names
Evac-Q-Mag®[OTC]

Generic Available

Yes


Synonyms
Citrate of Magnesia

Pharmacological Index

Laxative, Saline; Magnesium Salt


Use

Evacuation of bowel prior to certain surgical and diagnostic procedures or overdose situations


Pregnancy Risk Factor

B


Contraindications

Renal failure, appendicitis, abdominal pain, intestinal impaction, obstruction or perforation, diabetes mellitus, complications in gastrointestinal tract, patients with colostomy, ileostomy, ulcerative colitis or diverticulitis


Warnings/Precautions

Use with caution in patients with impaired renal function, especially if Clcr <30 mL/minute (accumulation of magnesium which may lead to magnesium intoxication); use with caution in digitalized patients (may alter cardiac conduction leading to heart block); use with caution in patients with lithium administration; use with caution with neuromuscular blocking agents, CNS depressants


Adverse Reactions

1% to 10%:

Endocrine & metabolic: Hypermagnesemia

Gastrointestinal: Abdominal cramps, diarrhea, gas formation

Respiratory: Respiratory depression


Overdosage/Toxicology

Serious, potentially life-threatening electrolyte disturbances may occur with long-term use or overdosage due to diarrhea; hypermagnesemia may occur. CNS depression, confusion, hypotension, muscle weakness, blockage of peripheral neuromuscular transmission.

Serum level >4 mEq/L (4.8 mg/dL): Deep tendon reflexes may be depressed

Serum level greater than or equal to 10 mEq/L (12 mg/dL): Deep tendon reflexes may disappear, respiratory paralysis may occur, heart block may occur

I.V. calcium (5-10 mEq) will reverse respiratory depression or heart block; in extreme cases, peritoneal dialysis or hemodialysis may be required.

Serum level >12 mEq/L may be fatal, serum level greater than or equal to 10 mEq/L may cause complete heart block


Mechanism of Action

Promotes bowel evacuation by causing osmotic retention of fluid which distends the colon with increased peristaltic activity


Pharmacodynamics/Kinetics

Absorption: Oral: 15% to 30%

Elimination: Renal


Usual Dosage

Cathartic: Oral:

<6 years: 0.5 mL/kg up to a maximum of 200 mL repeated every 4-6 hours until stools are clear

6-12 years: 100-150 mL

Adults greater than or equal to 12 years: 1/2 to 1 full bottle (120-300 mL)


Reference Range

Serum magnesium:

Adults: 2.2-2.8 mg/dL ~1.8-2.3 mEq/L


Test Interactions

magnesium; protein, calcium (S), potassium (S)


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

Magnesium products may prevent gastrointestinal absorption of tetracyclines by forming a large ionized chelated molecule with the tetracyclines in the stomach. Tetracyclines should be given at least 1 hour before magnesium.


Patient Information

Take with a glass of water, fruit juice, or citrus flavored carbonated beverage to improve taste, chill before using; report severe abdominal pain to physician


Nursing Implications

To increase palatability, manufacturer suggests chilling the solution prior to administration


Dosage Forms

Solution, oral: 300 mL


References

Chernow B, Smith J, Rainey TG, et al, "Hypomagnesemia: Implications for the Critical Care Specialist," Crit Care Med, 1982, 10(3):193-6.

Gams JG, "Clinical Significance of Magnesium: A Review," Drug Intell Clin Pharm, 1987, 21(3):240-6.

Vuignier BI, Oderda GM, Gorman RL, et al, "Effects of Magnesium Citrate and Clidinium Bromide on the Excretion of Activated Charcoal in Normal Subjects," DICP, 1989, 23(1):26-9.


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