Home Drug Guide Magnesium Sulfate, Potassium Chloride, Potassium Phosphate Monobasic, Sodium Chloride, Sodium Phosphate (Tis-u-sol)

Drug Guide

Generic Name

Magnesium Sulfate, Potassium Chloride, Potassium Phosphate Monobasic, Sodium Chloride, Sodium Phosphate (Tis-u-sol)

Brand Names Tis-u-sol

Classification

Therapeutic: Electrolyte replacement and fluid therapy

Pharmacological: Electrolytes and salts

FDA Approved Indications

Electrolyte replenishment in deficiency states
Fluid and electrolyte maintenance during surgery or critical illness

Mechanism of Action

Provides essential electrolytes that participate in numerous physiological processes, including nerve conduction, muscle contraction, and osmotic balance.

Dosage and Administration

Adult: Dosing varies based on clinical need; typically administered intravenously under medical supervision.

Pediatric: Dosing adjusted based on age, weight, and clinical condition; administered under supervision.

Geriatric: Cautious use due to risk of electrolyte imbalance; monitor levels closely.

Renal Impairment: Use with caution; adjust doses according to electrolyte levels and renal function.

Hepatic Impairment: No specific adjustments generally required.

Pharmacokinetics

Absorption: IV administration ensures direct entry into bloodstream.

Distribution: Widely distributed in body fluids.

Metabolism: Not metabolized; excreted unchanged.

Excretion: Primarily renal excretion.

Half Life: Varies; magnesium and potassium have half-lives of approximately 4-6 hours, depending on renal function.

Contraindications

Hypermagnesemia, Hyperkalemia, Renal failure, Severe dehydration

Precautions

Use cautiously in patients with cardiac disease, hepatic impairment, or electrolyte disturbances. Close monitoring required.

Adverse Reactions - Common

Vasodilation leading to hypotension (Uncommon)
Flushing, feeling of warmth (Common)

Adverse Reactions - Serious

Arrhythmias, Cardiac arrest (with severe hyperkalemia or hypermagnesemia) (Rare)

Drug-Drug Interactions

Potentiates effects of other neuromuscular blocking agents
Increases risk of hyperkalemia with certain medications

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor electrolytes, renal function, cardiac status, and vital signs.

Diagnoses:

Risk for electrolyte imbalance
Risk for impaired cardiac output

Implementation: Administer cautiously, monitor serum levels, and adjust dosing accordingly.

Evaluation: Electrolyte levels within normal range, stable cardiac status, absence of adverse reactions.

Patient/Family Teaching

Report signs of irregular heartbeat, weakness, or swelling.
Understand the importance of laboratory monitoring and follow-up.
Adherence to prescribed dosing and instructions.

Special Considerations

Black Box Warnings:

Administer cautiously to avoid toxicity, especially in renal impairment.

Genetic Factors: No specific genetic considerations known.

Lab Test Interference: May alter serum magnesium, potassium, phosphate, and sodium measurements.

Overdose Management

Signs/Symptoms: Signs of hypermagnesemia (muscle weakness, decreased reflexes, respiratory depression), hyperkalemia (muscle weakness, arrhythmias).

Treatment: Discontinuation of infusion, supportive care, calcium gluconate for magnesium toxicity, sodium bicarbonate or insulin plus glucose for hyperkalemia.

Storage and Handling

Storage: Store at room temperature, protected from moisture.

Stability: Stable under recommended storage conditions.