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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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domingo, 4 de octubre de 2020

Magnesium AF

The PharmERToxGuy - By Bryan D. Hayes - September 24, 2020
Today’s pearl is a continuation of Pearl 42: Medication Pearls for Atrial Fibrillation Management in the ED and reviews the role of magnesium for the treatment of atrial fibrillation.

Does magnesium reduce HR? How much and how fast to administer?

"Key teaching point: Magnesium sulfate for rapid AF needs to be administered over 10-20 minutes (rather than 1-2 hours) to achieve an effect.
Bottom Line: Magnesium seems to be safe and moderately effective for reducing heart rate in rapid AF. Even in the studies where magnesium was less effective than an active comparator, it still demonstrated some reduction in HR. Therefore, it seems reasonable to consider administering magnesium 2-4 gm IV as an adjunctive therapy while you are choosing between a calcium channel blocker or beta blocker as the primary rate-control agent. In some cases, you may find magnesium is enough to achieve lenient HR goals (ie, < 110 bpm). Monitor HR and BP appropriately.