(168) Is It Time to BAG the Old Ways of MAG? Decrease Infusion Time of IV Magnesium to Improve Patient Care

Poster Abstract:

Background: Hypomagnesemia is a common issue in patients with cancer due to magnesium wasting drugs like calcineurin inhibitors and epidermal growth factor inhibitors, chemotherapy sides effects such as diarrhea, and poor oral intake. This can occur in all cancer patients. Magnesium can be supplemented with either oral or intravenous repletion. To meet adequate magnesium levels, patients often require intravenous magnesium infusions due to limitations with oral magnesium. Historically, magnesium has been given over prolonged infusions due to concern for rapid elimination of magnesium after large doses administered. A prolonged infusion rate often creates many logistical issues including increased chair time and limiting the use of venous access. It is also inconvenient for the patient and may negatively impact quality of life. New data in bone marrow transplant patients suggests that patients have similar efficacy with faster rates. At UW Health, magnesium was given at a rate of 1g/60 minutes.

Objectives: The purpose of this project is to increase the infusion rate of IV magnesium without compromising therapeutic repletion, benefit, and safety. The primary outcome will be the grams of IV magnesium replaced per outpatient visit between the pre-intervention and post-intervention group. Secondary outcomes include assessment of differences in chair time between groups and incidence of critical magnesium lab values.

Methods: After literature evaluation and discussion with stakeholders, new rates of 4g/60 minutes, 2g/30 minutes, and 1g/15 minutes were pursued. The pre-intervention data was retrieved from our institution’s electronic health record from 6/1/22-6/1/23. The new increased magnesium rates were implemented on 11/1/23. Pre- and post-intervention data will be collected to evaluate the impact of the intervention and determine safety.

Results: Not available
Discussion/

Conclusion: Not available

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