Magnesium sulfate

Means of medical use Magnesium sulfate - bitter salt, sulphate magnesia - is a cardiovascular remedy, which is universally prescribed to stabilize blood pressure - in particular, with an attack of hypertension.

[1], [2], [3], [4], [5], [6]

Indications Magnesium sulfate

The spectrum of use of magnesium sulfate is quite extensive:

• attack of hypertension (crisis);
• ventricular tachyarrhythmia;
• convulsive conditions;
• eclampsic state;
• low magnesium content;
• accelerated consumption of magnesium in the body.

Magnesium sulfate is often used in combination with other medicines for premature labor, heart failure, intoxication with drugs of heavy metal salts, lead, barium salts.

[7], [8], [9], [10]

Release form

Magnesium sulfate is produced as an injectable preparation, which is a clear, colorless liquid substance.

The composition of the liquid is represented by magnesium sulfate heptahydrate, which contains 250 mg in 1 ml.

[11], [12]

Pharmacodynamics

Magnesium is very important for the human body:

• exhibits antagonistic calcium properties;
• takes part in the majority of metabolic processes;
• reduces the production of catecholamines;
• stabilizes the neurochemical impulses, the excitability of the muscular system;
• reduces the level of acetylcholine in the central nervous system and peripheral NA;
• helps to eliminate pain, cramps, spasms, etc.

In addition, the introduction of magnesium sulfate leads to the expansion of arterial vessels, lowers blood pressure, relieves stress on the heart muscle, stops the reaction of reperfusion injury of the heart muscle.

Magnesium prevents blood clotting and thrombus formation - this is due to a decrease in the production of thromboxane A ₂, the activation of prostacyclin and high-density lipoproteins.

A large amount of magnesium can lead to unfavorable isotropic action and to relaxation of smooth muscles.

[13], [14], [15], [16],

Pharmacokinetics

After the injection procedure, magnesium sulfate soon gets into the tissue structures and body fluids, while penetrating through the blood-brain barrier, through the placenta, also found in breast milk.

Excretion of magnesium sulfate is carried out through the kidneys.

The systemic effect of the drug is detected for 60 seconds after intravenous injection and 60 minutes after intramuscular injection. Duration of exposure:

• after IV infusion - half an hour;
• after a / m injection - up to 4 hours.

[17], [18], [19], [20], [21]

Dosing and administration

 Magnesium sulfate is used by injection, according to individual schemes:

• When there is a lack of magnesium in the body, 4 ml of the drug in / m is injected every 6 hours.
• At high blood pressure, 5 to 20 ml of medication is injected daily in / m, with a course of 15-20 administrations.
• With hypertension (with a crisis) is introduced from 10 to 20 ml IM or in / in slowly.
• With violations of the heart rhythm, intravenous administration of 4-8 ml of medication is used for 5-10 minutes. If necessary, repeat the infusion.
• In ischemic stroke, intravenous injections of 10-20 ml of medication are used daily for a week.
• To stop the convulsive syndrome use 5 to 20 ml in the form of IM injections.
• Patients with toxicosis of pregnant women are injected 10-20 ml to 2 times a day IM.
• To ease pain during labor, inject from 5 to 20 ml IM.
• Intoxic damage with heavy metals is eliminated by intravenous infusion of 5-10 ml of magnesium sulfate.

Use Magnesium sulfate during pregnancy

Pregnant women are treated with magnesium sulfate only in extreme cases, if the expected effect of the drug exceeds the potential danger to the fetus in terms of its importance.

Injection of magnesium sulfate on the eve or during labor may affect the contractility of uterine musculature. It is necessary to take into account and be ready to use medicines to stimulate delivery.

Breastfeeding for the duration of treatment Magnesium sulfate is discontinued.

Contraindications

Magnesium sulfate should not be used:

• with hypersensitivity to the composition of the drug;
• with low blood pressure;
• with a delayed heart rate (less than 55 bpm);
• with atrioventricular block;
• with a lack of calcium in the body;
• with oppressed respiratory function;
• when exhausted;
• with a clear disorder of renal function;
• with severe liver damage;
• with muscle weakness;
• with oncological pathologies.

[22], [23], [24], [25]

Side effects Magnesium sulfate

Treatment with Magnesium sulfate can be accompanied by unforeseen side effects:

• a significant decrease in blood pressure, slowing of the heart rate, arrhythmias, coma, up to cardiac arrest;
• shortness of breath, respiratory depression;
• pain in the head, dizziness, a feeling of fatigue, drowsiness, impaired consciousness, anxiety, trembling in the limbs and fingers;
• weakness of the musculature;
• dyspepsia;
• allergy;
• redness of the skin, rash, itching;
• an increase in daily diuresis;
• atony of the uterus;
• a decrease in the level of calcium in the blood, hyperosmolar dehydration;
• edema and reaction at the injection site.

[26], [27]

Overdose

Probable signs of an infusion of an excessively large volume of magnesium sulphate can be:

• weakening and loss of tendon reflexes;
• changes on ECG - extended PQ and extended QRS;
• respiratory depression;
• arrhythmia;
• change in cardiac conduction up to a stop of cardiac activity.

Additional symptoms may include increased sweating, anxiety, general retardation, an increase in daily diuresis, uterine atony.

The treatment is done with calcium-based medications - they are administered intravenously, without haste. Possible additional use of diuretics, cardiovascular drugs, oxygen inhalations, artificial overhead, and in severe situations - peritoneal dialysis, or hemodialysis.

[28]

Interactions with other drugs

Injectable Magnesium sulfate enhances the effect of medications that inhibit the processes in the central nervous system (narcotic and non-narcotic analgesics).

Combined treatment with muscle relaxants and Nifedipine enhances neuromuscular blockade.

Soporific medications, drugs and antihypertensive medications in combination with magnesium sulfate can affect the inhibition of the respiratory system.

Cardiac glycosides can cause heart rhythm disturbances.

In combination with magnesium sulfate, the effectiveness of antithrombotic medications, isoniazid, MAO inhibitors, vitamin K antagonists is reduced.

There are cases of delayed withdrawal Mexiletina.

In the combination of magnesium sulfate and propafenone, the effect of two drugs is observed to increase, but the degree of their toxicity also increases.

Magnesium sulfate negatively affects the absorption of antimicrobial agents of the tetracycline group, weakens the effects of Tobramycin and Streptomycin.

Magnesium sulfate is not chemically combined with solutions of calcium, with ethyl alcohol, carbonates, alkaline phosphates, arsenic, strontium, salicylates, bicarbonates.

[29], [30], [31], [32]

Storage conditions

Magnesium sulfate is stored in the original packaging, in rooms with a temperature of up to + 25 ° C, in places difficult to reach for children.

[33], [34]

Shelf life

Magnesium sulfate can be stored for up to 2 years, observing the appropriate conditions.

[35], [36], [37]