Magnesium sulfate (When ATH A06AD04)

When ATH:
A06AD04

Characteristics of magnesium sulfate

Colorless prisms, vyvetrivayuschiesya air. It is very readily soluble in water (1:1 Cold and 3,3:1 boiling); almost insoluble ethanol. Aqueous solutions are bitter-salty taste.

The pharmacological action of magnesium sulfate

Anticonvulsant, antiarrhythmic, vazodilatirtee, gipotenzivnoe, antispasmodic, sedation, laxative, zhelchegonnoe, tokoliticheskoe.

The use of magnesium sulfate

Inaektsionno: hypertensive crisis (incl. with symptoms of cerebral edema), eclampsia, encephalopathy, gipomagniemiya, incl. prevention (inadequate or unbalanced diet, oral contraceptives, diuretics, muscle relaxants, Saint Martin's evil), increased need for magnesium (pregnancy, period of growth, recovery period, stresses, excessive sweating), Acute hypomagnesemia (signs of tetany, myocardial dysfunction), cramps in gestosis, threat of premature birth; ventricular arrhythmias, associated with prolongation of the QT interval; ventricular tachycardia type "pirouette"; the occurrence of arrhythmias in the background of low plasma concentrations of potassium and / or magnesium, epileptic syndrome, urinary retention, poisoning by salts of heavy metals (mercury, arsenic, lead).

Inside: constipation, kholangit, cholecystitis, gallbladder dyskinesia on hypotonic type (for tyubazh), duodenal intubation (for cystic bile portion), purgation before diagnostic procedures. Poisoning by salts of heavy metals (mercury, arsenic, lead, barium).

Magnesium sulfate – Contraindications

Hypersensitivity, gipermagniemiya. For injecting (additionally): hypotension, depression of the respiratory center, vыrazhennaya bradycardia, OF блокада, severe renal insufficiency (creatinine clearance less than 20 ml / min), prenatal (for 2 hours before delivery).

For the purpose inside (additionally): appendicitis, rectal bleeding (incl. expected), ileus, degidratatsiya.

Magnesium sulfate – Restrictions apply

For injecting: myasthenia, respiratory diseases, impairment of renal function, chronic renal failure, acute inflammatory diseases of the gastrointestinal tract. For the purpose inside: heart block, myocardial damage, chronic renal failure.

The use of magnesium sulfate during pregnancy and lactation

Studies in animals / in application of magnesium sulfate did not spend. Unknown, whether the magnesium sulfate have adverse fetal effects in / in the introduction to pregnant women or affect reproductive capacity. It should be used during pregnancy only when necessary.

For parenteral administration in eclampsia in pregnant women quickly passes through the placenta and reaches the fetus serum concentrations, roughly equal to those of the mother. Effects of magnesium sulfate in neonates are similar to those of the mother and can include hypotonia, giporefleksiю, respiratory depression, if the woman received magnesium sulfate before delivery. Therefore, usually magnesium sulfate was not used in the prenatal period (for 2 hours before delivery), except, When you want to prevent seizures in eclampsia. Magnesium sulfate may be administered continuously / drip at a rate of 1-2 g each hour provided, that careful monitoring of plasma concentrations of magnesium, FROM, respiratory rate and deep tendon reflexes.

Magnesium sulfate – Side effects

When injected,: signs and symptoms of gipermagniemii-bradycardia, diplopia, flushing, Sweating, decrease in blood pressure, inhibition activity of the heart and central nervous system, at a concentration of Mg²⁺ blood 2-3, 5 mmol/l is reduced deep tendon reflexes; 2,5-5 mmol/l — extension PQ interval and QRS complex on the ECG extension; 4-5 mmol/l — loss of deep sukhojilnykh reflexes; 5-6.5 mmol/l is oppression respiratory Centre; 7,5 mmol/l — violation of cardiac conductance; 12,5 mmol/l-cardiac arrest. Besides, alarm, headache, weakness, metroparalysis, gipotermiя. Reported symptoms of hypocalcemia with tetany secondary when arresting eclampsia. At excessively high plasma concentrations of magnesium (for example, when a very rapid on / in, in renal failure): nausea, paraesthesia, vomiting, polyuria.

If ingestion: nausea, vomiting, diarrhea, exacerbation of inflammatory diseases of the gastrointestinal tract, electrolyte imbalance (fatigue, asthenia, confusion, arrhythmia, convulsions), flatulence, abdominal pain, spastic nature, thirst, signs and symptoms gipermagniemii (particularly in renal failure).

Interaction of magnesium sulfate

Acceptance of nephrotoxic drugs, such as amphotericin B, cisplatin, cyclosporine, gentamicin, increases the need for magnesium. Loop and thiazide diuretics, long-term use can reduce the ability of the kidneys magniysohranyayuschuyu, which leads to hypomagnesemia (requires monitoring of levels of magnesium in the blood). Potassium-sparing diuretics, long-term use increases the tubular reabsorption of magnesium in the kidney, which can cause gipermagniemiya, especially in patients with renal insufficiency. Calcium salts (for / in the) neutralize the effects of magnesium sulfate, administered parenterally. However, calcium gluconate or calcium chloride is used for the removal of toxic effects in gipermagniemii. A joint reception drugs for calcium and magnesium oral drugs may lead to increased serum concentrations of calcium or magnesium in susceptible patients, mainly in patients with renal insufficiency. Deprimiruyuschee effect on the CNS when administered parenterally increases when combined with means, CNS depressants. It was reported on the development of hypomagnesemia in patients, simultaneously receiving digitalis glycosides, which can lead to digitalis intoxication (magnesium levels should be monitored in serum). With the simultaneous use of oral drugs can reduce the absorption of magnesium and blood concentration of digitalis glycosides (need for extreme caution, especially in cases, when applied to the same I / calcium salt; possible cardiac conduction and heart block. Muscle relaxants enhance neuromuscular blockade. Reduces absorption etidronovoy acid, tetracyclines (non-absorbent forms complexes with oral tetracyclines). Excessive use of alcohol or glucose increased renal excretion of magnesium.

Magnesium sulfate – Overdose

Symptoms when administered parenterally: the disappearance of a knee-jerk (classic clinical sign of the beginning of the intoxication), nausea, vomiting, a sharp drop in blood pressure, bradycardia, respiratory depression and CNS.

Treatment: as an antidote is administered in / in (slowly) calcium supplements (calcium chloride or calcium gluconate-5-10 ml 10%), or oxygen therapy, inhalation of carbogen, IVL, pyeritonyealinyi dialysis and hemodialysis ili, symptomatic agents (correcting the central nervous system and cardiovascular system).

Symptoms of ingestion: severe diarrhea.

Treatment: symptomatic.

Magnesium sulfate – Dosing and Administration

/ M, I /, inside. V / m or / (slowly, first 3 ml — for 3 m) -5-20 ml 20-25% solution daily 1-2 times a day. If you have arsenic poisoning, mercury, tetraètilsvincom-in/5-10 ml of 5-10% solution. For short seizures in children/m 20-40 mg/kg (0,1-0.2 mL/kg 20% solution) / m. The maximum dose - 40 g / day (160 mg / day).

Inside: as a laxative (at night or on an empty stomach) adults — on 10-30 g 0,5 cup water, children - a rate 1 d of 1 year of life; as jelchegng-on 1 st.lojke 20-25% solution 3 once a day, When the duodenal sounding injected through the probe 50 ml 25% solution or 100 ml 10% solution. When poisoning soluble salts of barium washed stomach 1% solution of magnesium sulfate, or give him inside (20-25 G 200 ml of water to form a non-toxic barium sulphate). When mercury poisoning, Arsenic, Lead is introduced into / in (5-10 Ml 5-10% solution).

Magnesium sulfate – Precautions

Long-term treatment is recommended to monitor blood pressure, activity of the heart, tendon reflexes, renal function, respiration rate. If necessary, the simultaneous on / in the use of magnesium salts and calcium should be administered in different vein.

Patients with severe renal impairment should not receive more 20 g of magnesium sulphate (81 mmol Mg²⁺) during 48 no, patients with oliguria, or severe renal impairment should not be given magnesium sulfate / too fast.