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Pronunciation |
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(mag
NEE zhum SIT
rate) |

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U.S. Brand
Names |
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Evac-Q-Mag®[OTC] |

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Generic
Available |
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Yes |

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Synonyms |
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Citrate of Magnesia |

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Pharmacological Index |
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Laxative, Saline; Magnesium Salt |

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

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Pregnancy Risk
Factor |
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B |

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

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Warnings/Precautions |
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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 |

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Adverse
Reactions |
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1% to 10%:
Endocrine & metabolic: Hypermagnesemia
Gastrointestinal: Abdominal cramps, diarrhea, gas formation
Respiratory: Respiratory depression |

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Overdosage/Toxicology |
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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 |

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

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Pharmacodynamics/Kinetics |
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Absorption: Oral: 15% to 30%
Elimination: Renal |

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Usual Dosage |
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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) |

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Reference Range |
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Serum magnesium:
Adults: 2.2-2.8 mg/dL ~1.8-2.3 mEq/L |

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Test
Interactions |
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magnesium;
protein,
calcium (S),
potassium
(S)
|

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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |

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Dental Health:
Effects on Dental Treatment |
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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. |

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Patient
Information |
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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 |

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

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Dosage Forms |
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Solution, oral: 300 mL |

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References |
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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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