Magnesium sulfate - instructions for use, side effects, reviews, price. Magnesium sulfate - a laxative for quick bowel cleansing
Magnesium sulfate or magnesium sulfate (Magnesii sulfas) is the most common dosage form of magnesium.
The active ingredient of the same name, magnesium sulfate, is a magnesium salt of sulfuric acid. Chemical formula – MgSO 4. These are white or colorless rhombic crystals, with a bitter-salty taste. Magnesium sulfate is hygroscopic and dissolves well in water. Moreover, with increasing water temperature, the solubility of magnesium also increases. In some cases, the chemical interaction of magnesium sulfate and water leads to the formation of mineral compounds of crystalline hydrates. Magnesium sulfate is soluble in diethyl ether and in glycerol, and practically insoluble in ethyl alcohol and in acetone.
Mechanism of action
The medicinal effect of magnesium sulfate is due to the ability of its constituent magnesium to influence many physiological and biochemical processes in the human body. Magnesium enters the body as part of such food products like meat, fish, seafood. At the same time, about 40% of the incoming magnesium is absorbed in the intestines. The daily requirement for magnesium for an adult is about 300-400 mg, and the body contains about 70 g of magnesium in total. 60% of this amount is in the bones, and the rest is in other tissues and biological fluids body.
Magnesium, along with other substances, is classified as a macronutrient, thereby emphasizing its biological significance and relative great content. After all, in terms of content, magnesium ranks 4th, and is inferior to other macroelements - sodium, potassium and calcium. Moreover, there is much more of it in the cell than in the extracellular space - like potassium, it is an intracellular macroelement. More than 80% of intracellular magnesium is present in mitochondria, where it is closely bound to ATP. This macroelement ensures the synthesis of nucleic acids, enzymes, and is involved in protein, fat and carbohydrate metabolism, neutralizes free radicals and other toxins.
Magnesium is also a physiological antagonist of another macroelement, calcium. Its action is aimed at neutralizing the effects produced by calcium. It is on this antagonism with calcium that the use of magnesium sulfate in clinical practice. Unlike magnesium, calcium is an extracellular macronutrient. Its content outside the cell is 25 times higher than inside the cell. This difference (gradient) is due to the action of the enzyme calcium-dependent ATPase, which pushes calcium out of the cell. The flow of calcium from outside to inside the cell along a gradient is ensured by specific carrier proteins. These transporters are located on the cell membrane, interact with calcium, and transport it into the cell. These transporters are called calcium channels.
The physiological role of calcium is diverse. It strengthens cell membranes and reduces their permeability, ensuring bone strength. The entry of calcium into smooth muscle cells triggers the interaction of contractile proteins, actin and myosin, which leads to smooth muscle contraction in various organs and anatomical structures. In addition, calcium ensures neuromuscular transmission - impulse transfer from nerve fiber to skeletal muscles.
This happens in the following way. There is a gap junction or synapse between a nerve fiber and a muscle fiber. The nerve impulse is transmitted through the synapse thanks to acetylcholine. It's biological active substance located in the presynaptic (located in front of the synapse) nerve fiber in microscopic vesicles or vesicles. Under the influence of calcium, acetylcholine is released from the vesicles into the synaptic cleft, as a result of which the impulse passes along the synapse from the nerve to the muscle.
Calcium also ensures the propagation of the impulse through the conduction system of the heart with subsequent contraction of the myocardium. The distribution of nerve impulses in the brain structures ensures adequate functioning of the CNS (central nervous system). However, it should be noted that many pathological processes in the central nervous system and in other organs and tissues pass with the participation of calcium.
Contraction of the muscle membrane of small peripheral arteries(atherioles) leads to their spasm and an increase in blood pressure (BP). Contraction of the heart (coronary) vessels against the background of intravascular atherosclerosis and thrombosis leads to myocardial infarction. A similar process in the cerebral vessels is manifested by ischemic stroke. Myocardial infarction and cerebral stroke can be regarded as a disaster. The severity of damage in these diseases is further aggravated by the so-called. the phenomenon of theft.
This phenomenon is characterized by the fact that the blood is in areas of narrowing and rushes mainly to where the lumen of the vessels is normal. Ischemic disease heart disease and myocardial infarction are often complicated by arrhythmias. Some of the arrhythmias, for example, ventricular extrasystole, paroxysmal supraventricular tachycardia, are life-threatening, and are also caused by excessive calcium activity.
Increased excitation processes in the central nervous system, in which calcium also plays a significant role, is accompanied by sleep disturbances, feelings of anxiety and fear. Pathological generation of impulses in some parts of the central nervous system leads to the development muscle cramps. Increased contractility smooth muscle gravid uterus can lead to miscarriages and premature birth.
Magnesium, being a calcium antagonist, blocks calcium channels, and thereby prevents the extracellular penetration of calcium with the development of corresponding pathological effects. Under the influence of magnesium, arterioles relax and blood pressure decreases, which is especially important when hypertension. Expansion of the lumen coronary vessels accompanied by improved blood supply to the myocardium. In addition, it has been found that magnesium prevents the formation of intravascular blood clots. Therefore, the risk of developing cerebral strokes and myocardial infarction after taking magnesium sulfate is reduced.
With the expansion of coronary and cerebral vessels the phenomenon of theft is eliminated. Magnesia also protects blood vessels from damage in severe diseases, in particular diabetes.
Magnesium sulfate will slow down the conduction of impulses through the myocardium, and thereby prevent the development of severe arrhythmias. Blockade of calcium channels in the central nervous system is accompanied by the inhibitory effect of magnesium on brain structures, followed by sedation. Irritability and anxiety disappear, sleep normalizes. Therefore, magnesium is rightly called the anti-stress element or the metal of calm.
In contrast to calcium, magnesium inhibits the release of acetylcholine and slows neuromuscular transmission. This property of magnesium is used to eliminate convulsive syndrome. Magnesia has a tocolytic effect - it relaxes the maca and reduces its contractility. Sedative, anticonvulsant, antispasmodic, tocolytic and hypotensive effect We make magnesium sulfate the drug of choice for conditions such as acute disorders cerebral circulation of ischemic type, traumatic brain injury, as well as eclampsia. The latter condition is a severe form of late toxicosis of pregnancy (preeclampsia) with increased blood pressure, generalized vascular spasm and convulsions.
At the same time, an overdose of mania sulfate is also fraught with complications - severe uncontrollable hypotension, respiratory and cardiac depression, and inhibition in the central nervous system. Therefore, the recommended dosages should be strictly followed. Magnesium sulfate is poorly absorbed in the intestine, and therefore, to achieve the required effects, it is used by injection - intramuscularly, intravenously by stream, and intravenously by drip. With intravenous drip administration it is often included in the so-called. polarizing mixture with glucose, inulin, and potassium. Insulin facilitates the intracellular transport of glucose, and at the same time potassium and magnesium.
Most of the magnesium taken orally is not absorbed, but remains in the intestinal lumen. Wherein osmotic pressure in the intestines increases, water is released into the intestinal lumen. The volume of intestinal contents increases, peristalsis increases reflexively, and all contents come out. The laxative effect is accompanied by increased flow of bile, caused by relaxation of the smooth muscles of the biliary tract and the release of the hormone cholecystokinin by the duodenal mucosa under the influence of magnesium. Magnesia is also used as an antidote for salt poisoning. heavy metals. When magnesium reacts with these salts, non-toxic and harmless sulfates are formed, which are excreted through the intestines.
A little history
Magnesia sulfate was isolated from mineral spring water back in 1695. The new substance, which has a bitter taste, was called Epsom salt, which was used as a laxative over the following centuries. In the twentieth century, the role of magnesium in physiological processes and an injection form of the drug was synthesized, which is actively used in Russia and abroad.
Synthesis technology
Magnesium sulfate is obtained during chemical reactions magnesium compounds (oxide, hydroxide, carbonate) with sulfuric acid.
Some weight loss methods recommend magnesia as a laxative. They say that an increase in stool volume will automatically lead to weight loss. But everything is much more complicated. The problem is that the systematic use of laxatives will be complicated over time by chronic irritation and inflammation of the intestines. Not only are they excreted in feces ballast substances, but also those that are necessary for normal digestion and metabolism. 
Release forms
- Powder for oral administration;
- Ampoules of 25% solution 5 and 10 ml.
Occasionally you can find a 20% concentration of the drug or 20 ml ampoule. Magnesia is produced by many Russian pharmaceutical companies under a generic name active substance. There are no generics. In addition to magnesium sulfate, magnesium in the form of various compounds and in combination with other substances is present in such pharmaceutical preparations as Panangin, Asparkam, Magne B6, Magnerot, as well as in numerous dietary supplements.
Indications for use
For injection:
- Hypertensive crisis;
- Encephalopathy;
- Ventricular extrasystole and paroxysmal tachycardia;
- Eclampsia, eclamptic convulsions;
- Epilepsy;
- Other conditions accompanied by convulsive syndrome;
- Urinary retention;
- Threat premature birth;
- Poisoning with salts of heavy metals;
- Conditions with an increased need for magnesium - pregnancy, stress, increased sweating, youthful growth, recovery from serious illnesses;
- Manifestations of magnesium deficiency (hypomagnesemia) – decreased myocardial contractility, arrhythmias, convulsive syndrome;
- Prevention of hypomagnesemia in poor nutrition, alcohol abuse, long-term use contraceptives and diuretics.
For oral administration:
- Constipation;
- Cleansing the intestines before diagnostic procedures;
- Duodenal sounding;
- Cholangitis, cholecystitis;
- Biliary dyskinesia of the hypotonic type;
- Poisoning with salts of heavy metals.
Dosages
The injection solution is administered intramuscularly, slowly intravenously, or intravenously by drip. In the latter case, I dissolve it in saline solutions or in a polarizing mixture. Adults are administered 5-20 ml 1-2 times a day. The maximum dose for adults in terms of dry matter is 40 g. For children daily dose administered magnesium sulfate is selected at the rate of 20-40 mg/kg.
Orally, for a laxative effect, take 10-30 mg of powder, previously dissolved in half a glass of warm water. Children take 1 g/kg. The drug is taken at night or on an empty stomach. For a choleretic effect, a 25% solution of Magnesium sulfate is taken orally, 1 tablespoon 3 times a day, and during duodenal intubation, 50 ml of a 25% solution is injected into the gastric tube.
Pharmacodynamics
Only 20% of magnesium sulfate taken orally is absorbed in the intestines. When administered intramuscularly or intravenously, it is distributed in all tissues of the body and penetrates the brain through the blood-brain barrier. When administered intravenously, the effect develops almost instantly and lasts half an hour; when administered intramuscularly, it develops after 1 hour and lasts 3-4 hours. Defecation after oral administration occurs within 4-6 hours. The drug is excreted by the kidneys. The rate of excretion depends on the concentration of magnesium in the blood plasma. When excreted in urine, a slight diuretic effect is observed.
Side effects
For intramuscular and intravenous administration:
- The cardiovascular system: decreased blood pressure, bradycardia, slowing of cardiac conduction up to cardiac arrest.
- Respiratory system: shortness of breath, paralysis respiratory center.
- CNS: headache, dizziness, general weakness, increased fatigue, confusion, diplopia (double vision), severe sedation, slurred speech, suppressed tendon reflexes, convulsions.
- Gastrointestinal tract: nausea, vomiting, diarrhea, exacerbation of existing inflammatory diseases of the stomach and intestines, cramping abdominal pain, flatulence, thirst.
- Leather: hyperhidrosis (excessive sweating).
- Kidneys: polyuria (increased volume of urine excreted).
- Reproductive system: uterine atony.
Contraindications
- Hypersensitivity to magnesium sulfate;
- Hypotension;
- Bradycardia;
- Slowing of atrioventricular conduction;
- Severe chronic renal failure;
- Depression of the respiratory center;
- Prenatal period – 2 hours before birth;
- For oral administration - intestinal obstruction, rectal bleeding, appendicitis, general dehydration.
Interaction with other drugs
- Peripheral muscle relaxants– enhancing the effect of these drugs.
- Tetracyclines– slowing down the absorption of these drugs in the intestines.
- Gentamicin– danger of respiratory arrest due to an increase in the concentration of magnesium in the blood plasma.
- Nifedipine– muscle weakness.
- Anticoagulants, cardiac glycosides, phenothiazine derivatives– reduction in the effectiveness of these drugs.
- Calcium chloride or calcium gluconate– used as an antidote (antidote) for an overdose of Magnesium sulfate.
Pregnancy and lactation
Magnesium sulfate penetrates the placental barrier and is therefore contraindicated during pregnancy. IN obstetric practice it is used, but strict indications(preeclampsia, eclampsia due to high blood pressure and convulsive readiness). Magnesium sulfate penetrates into breast milk, and its concentration in milk is 2 times higher than in blood plasma. Therefore, when breastfeeding it is also contraindicated. Otherwise, feeding is stopped.
Storage
Store at a temperature not exceeding 25 0 C. Shelf life – 5 years. The drug can be dispensed without a doctor's prescription.
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In 1 ml of ampoule solution - magnesium sulfate 250 mg.
Release form
- Powder for dissolution in water 10 g, 20 g, 25 g and 50 g.
- Solution in ampoules of 5 ml and 10 ml 20% or 25%.
Pharmacological group
Trace elements, vasodilators, sedatives.
pharmachologic effect
Sedative, antispasmodic.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
What is magnesium sulfate? The State Pharmacopoeia defines magnesium sulfate (formula MgSOi) as medicine and indicates the standards for its production and the highest doses of use. The product “magnesium sulfate” is assigned the code OKPD24.42.13.683.
With water, this substance forms hydrates, the most important of which is heptahydrate - bitter, or Epsom salt - This magnesia , as it is more commonly called, which is used in medicine. Available in powder form, from which a solution or suspension is prepared for oral administration and in ampoules for intramuscular and intravenous administration.
Depending on the route of administration, it has different effects on the body. At - sedative , diuretic , vasodilator , anticonvulsant , hypotensive , antispasmodic , antiarrhythmic , tocolytic , hypnotic .
Mechanism of action anticonvulsant due to the fact that magnesium reduces the release of the neurotransmitter acetylcholine from synapses, suppressing neuromuscular transmission, and has a depressant effect on the central nervous system.
Tocolytic action (relaxation of the uterine muscles) is explained by the fact that magnesium reduces the contractility of the uterus and increases blood flow in it.
Antiarrhythmic effect due to stabilization cell membranes and decreased excitability of cardiomyocytes. Effects after intravenous administration develop immediately, after intramuscular administration - after 1 hour.
At orally provides choleretic effect and serves laxative , which is used when or for cleansing the intestines, in case of blind probing, poisoning with salts of heavy metals (it is an antidote). The laxative effect is due to poor absorption in the intestine, in which osmotic pressure increases and water accumulates, which leads to dilution of the intestinal contents and increased peristalsis.
The injection solution can be used orally as a laxative. The onset of effect when taken orally after 1-3 hours, lasts 4-6 hours.
Magnesium sulfate has also found its use in cosmetology in the manufacture of emulsions, lotions and creams. It is used as a relaxing bath salt that relieves muscle tension.
Pharmacokinetics
At parenteral administration (injections) penetrates the BBB. In breast milk it creates concentrations that are 2 times higher than the concentrations in the blood. Excreted by the kidneys, the rate of excretion is proportional to the level glomerular filtration. Intensifies when removed diuresis .
At oral administration poorly absorbed in the intestines. With malabsorption and consumption of fatty foods, magnesium absorption is reduced. Deposited in bones, muscles, kidneys, myocardium.
Indications for use
- hypomagnesemia , tetany ;
- ventricular ;
- , crisis state With cerebral edema ;
- urinary retention;
- brain concussion ;
- , ;
- barium chloride poisoning , salts of heavy metals ;
- (consisting of complex therapy).
Magnesium Sulfate powder is used orally for:
- gallbladder dyskinesias , cholangitis And (for performing tuba tests);
- duodenal intubation ;
- poisoning with salts of heavy metals;
- to cleanse the intestines.
Contraindications for Magnesium Sulfate
- arterial hypotension ;
- severe chronic renal failure;
- pronounced bradycardia ;
- hypersensitivity;
- AV block;
- period before childbirth (2 hours);
- depression of the respiratory center.
Prescribe with caution when . Contraindications for oral administration: , intestinal bleeding ,intestinal obstruction , .
Side effects
With intravenous use: headache, polyuria, decreased blood pressure, nausea, severe sedation, uterine atony .
Signs hypermagnesemia : bradycardia, double vision, shortness of breath, slurred speech, asthenia, decrease and loss of tendon reflexes, depression of the respiratory center and impaired cardiac conduction.
When taken orally: vomiting, , exacerbation gastrointestinal diseases, , thirst, intestinal pain, disturbance electrolyte balance(fatigue, asthenia, cramps).
Instructions for use of Magnesium Sulfate (Method and dosage)
Instructions for use of the solution in ampoules
A 25% solution is most often used intravenously or intramuscularly. At Ghypertensive crises ,convulsive syndrome , spastic conditions 5–20 ml of the drug is prescribed.
At eclampsia - 10 – 20 ml of 25% solution up to 4 times a day.
For 0.1-0.2 ml per kg of weight of a 20% solution is administered intramuscularly.
For acute poisoning - IV 5–10 ml 10% solution.
Magnesium Sulfate powder, instructions for use
How to take magnesium sulfate as a laxative? Powder in an amount of 20-30 g is dissolved in 100 ml of water (preferably warm) and drunk at night or in the morning half an hour before meals. At chronic constipation do enemas - the same amount of powder per 100 ml of water. The drug can be used as a laxative only occasionally.
Method of using powder as a choleretic agent
Prepare a solution from 20 g of powder and 100 ml of water. Take 1 tablespoon 3 times a day before meals. At poisoning with heavy metal salts take a solution orally - 20-25 g per 200 ml of water. At duodenal intubation 50 ml of a 25% solution is injected through the probe.
Magnesium sulfate is also used as a fertilizer; a separate section is devoted to this.
Application as fertilizer
Magnesium sulfate is a fertilizer that is a source of magnesium and sulfur for agricultural and ornamental crops. This fertilizer is in the form of crystals white, highly soluble in water. Accelerates the growth of new shoots and increases the amount of harvest, improves the taste of vegetable crops by increasing the content of sugar, starch and vitamins. To prevent magnesium deficiency, it is recommended to add 50 to 100 g of bitter salt per m2 every year. During the growing season, carry out root and foliar feeding.
Application to plants causes growth and promotes vigorous flowering. For example, for roses, take 1 tablespoon of powder in a bucket of water and water each bush with 2 liters of this solution. Fertilizing is carried out in June and until mid-July, since it causes enhanced growth shoots. You can also carry out foliar feeding by spraying. For the working solution, take 20 g of the drug per 10 liters of water.
Overdose
An overdose with intravenous administration is manifested by the disappearance of the knee reflex, sharp decline blood pressure, nausea, vomiting, bradycardia, respiratory depression and central nervous system.
Treatment: solution / chloride IV slowly (antidote), oxygen therapy , artificial respiration, symptomatic therapy.
Overdose when taken orally - . Symptomatic treatment is carried out.
Interaction
Use with cardiac glycosides increases the risk of AV block, with muscle relaxants - neuromuscular blockade increases. At joint use with vasodilators, the hypotensive effect is enhanced. The likelihood of depression of the respiratory center and central nervous system increases when used with barbiturates And narcotic analgesics .
Calcium salts reduce the effect of the drug. A precipitate is formed with phosphate , polymyxin B , ,procaine hydrochloride , salicylates , drugs Ca2+ , ethanol , strontium salts , arsenic acid , barium .
Terms of sale
Over the counter.
Storage conditions
At temperatures up to 25 C.
Best before date
Use during pregnancy
The drug is used during pregnancy when there is a threat of premature birth. How anticonvulsant having hypotensive effect, it is the drug of choice for treatment and prevention seizures at eclampsia . Therapy is started if diastolic blood pressure is > 130 mm Hg. Art. Magnesium therapy is carried out for another 24–48 hours after birth. The criteria for stopping therapy are the disappearance of seizures, the absence of hyperreflexia and convulsive readiness, a persistent decrease in blood pressure, and normalization of diuresis. The use of this drug during labor is contraindicated because it reduces the contractile activity of the myometrium.
Analogues
Matches by ATX code 4th level:
Magnesium sulfate-Darnitsa , Cormagnesin .
Reviews of Magnesium Sulfate
Magnesium Sulfate powder is often used as a laxative, reviews of which are contradictory. The laxative effect manifests itself differently in everyone: more or less pronounced. Many people note a significant increase in peristalsis and the occurrence of abdominal pain. Not everyone can drink the bitter, unpleasant solution, which sometimes causes vomiting.
It must be remembered that taking the drug is contraindicated when , low blood pressure . Good effect gives this remedy during blind probing.
Magnesium Sulfate is used for weight loss - reviews are given below.
Magnesium Sulfate for weight loss
Before any diet, it is advisable to cleanse the intestines and this remedy is used once. Why can’t you often resort to this method of cleansing the intestines? Magnesium sulfate irritates the gastrointestinal mucosa, disrupts the water-salt balance and, with frequent use, leads to . It was said above how to take the powder to cleanse the intestines.
To lose weight, you can take baths by adding a glass of powder or more to the bath. Bath time is 15-20 minutes. You need to take a bath before going to bed, for a course of 15 procedures, carried out 2 times a week. After the procedure, you need to cover yourself with a warm blanket to achieve profuse sweating. The action is what is output excess liquid, swelling is eliminated and the metabolic processes. The weight loss effect occurs due to fluid loss, but after a while everything comes back. Many consider this method as an emergency means for losing weight - reviews confirm this.
Magnesium Sulfate price, where to buy
You can buy Magnesium Sulfate in all pharmacies in Moscow and other Russian cities. Magnesium Sulfate powder, the price of which depends on the number of grams, costs between 38-58 rubles.
- Online pharmacies in Russia Russia
- Online pharmacies in Ukraine Ukraine
- Online pharmacies in Kazakhstan Kazakhstan
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Magnesium sulfate powder 20 gMoscow pharmaceutical factory
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Magnesium sulfate 25% ampoules 5ml No. 10
Magnesium sulfate 25% ampoules 10ml No. 10
Magnesium sulfate (amp. 25% 10ml No. 10)
APPROVED
By order of the chairman
Committee for Control of Medical and
Pharmaceutical activities
Ministry of Health
Republic of Kazakhstan
From "____"______________201__
№ ________________
Instructions for medical use
Medicine
MAGNESIUM SULPHATE-DARNITSA
Magnesium sulfate - Darnitsa
International nonproprietary name
Solution for injection 25% 5 ml, 10 ml
Compound
1 ml of solution contains
active substance- magnesium sulfate 250 mg,
excipient- water for injections.
Description
Transparent colorless liquid.
Pharmacotherapeutic group
Plasma replacement and perfusion solutions. Additives to solutions for intravenous administration. Electrolyte solutions. Magnesium sulfate.
Code ATX В05ХА05
Pharmacological properties
Pharmacokinetics
Passes through the blood-brain barrier and placenta, excreted into breast milk, the concentration of which is 2 times higher than the concentration in blood plasma. Excreted by the kidneys, the rate of renal excretion is proportional to the concentration in the blood plasma and the level of glomerular filtration. The plasma concentration at which the anticonvulsant effect develops is 2-3.5 mmol/l.
Pharmacodynamics
When administered parenterally, it has a hypotensive, arteriolodilating, antiarrhythmic, sedative, anticonvulsant, diuretic, antispasmodic, and tocolytic effect. Replenishes magnesium deficiency in the body and is a physiological calcium antagonist. Regulates metabolic processes, neurochemical transmission and muscle excitability, prevents the entry of calcium ions through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral and central nervous system, has sedative, hypnotic or narcotic effects depending on the dose, and has an antispasmodic effect. Reduces the excitability of the respiratory center; when administered in high doses, it can cause respiratory depression.
The hypotensive and antiarrhythmic effects of magnesium are due to a decrease in the excitability of cardiomyocytes, restoration of ionic balance, stabilization of cell membranes, disruption of sodium flow, slow incoming calcium flow and one-way potassium flow, dilation of the coronary arteries, reduction of total peripheral vascular resistance, platelet aggregation, as well as antispasmodic and sedative effects.
The sedative and anticonvulsant effect of magnesium is associated with a decrease in the release of acetylcholine from neuromuscular synapses, inhibition of neuromuscular transmission, and a direct inhibitory effect on the central nervous system. nervous system.
The tocolytic effect develops due to inhibition of the ability to contract the myometrium (decreased absorption, binding and distribution of calcium in smooth muscle cells), vasodilation and increased blood flow in the uterus. Magnesium has an antispasmodic effect during urinary retention and is an antidote for poisoning with heavy metal salts.
Systemic effects develop almost instantly after intravenous and 1 hour after intramuscular administration, their duration is 30 minutes and 3-4 hours, respectively.
Indications for use
Hypertensive crisis, ventricular cardiac arrhythmias (pirouette-type tachycardia)
Eclampsia
Hypomagnesemia increased need in magnesium
In case of poisoning with salts of heavy metals, tetraethyl lead, soluble salts barium (antidote) in complex therapy
Method of administration and dose.
Prescribed intramuscularly, intravenously slowly or as an intravenous infusion. Freshly prepared infusion solutions cannot be stored for long periods of time and should be used immediately after preparation. The frequency of administration and dose are individual depending on the indications and therapeutic effect. At infusion administration the drug is diluted with 0.9% sodium chloride solution or 5% glucose. For intravenous injection, the rate of administration should usually not exceed 150 mg/min (0.6 ml/min), with the exception of the treatment of arrhythmias and eclampsia of pregnancy.
Hypomagnesemia. For moderately severe hypomagnesemia (0.5-0.7 mmol/l), adults are administered 4 ml (1 g of magnesium sulfate) intramuscularly every 6 hours.
For severe hypomagnesemia (< 0,5 ммоль/л) при intramuscular injection the total dose is increased to 1 ml/kg (250 mg/kg) and administered in parts over 4 hours. As an intravenous infusion for severe hypomagnesemia, 20 ml of the drug (5 g of magnesium sulfate) is added to 1 liter of 0.9% sodium chloride solution or 5% glucose and administered for at least 3 hours.
The maximum daily dose for intravenous administration is 72 ml (18 g). If necessary, infusions are repeated over several days.
Arterial hypertension. At arterial hypertension Stages I-II are administered intramuscularly daily at 5-10-20 ml. The course of treatment is 15-20 injections, while, along with a decrease in blood pressure, a decrease in the severity of angina pectoris may be observed.
Hypertensive crisis. Inject 10-20 ml intramuscularly or intravenously in a stream, slowly.
Cardiac arrhythmias. To relieve arrhythmias, 4-8 ml (1-2 g of magnesium sulfate) are administered intravenously over 5-10 minutes, repeat the injection if necessary (total administration of up to 4 g of magnesium sulfate).
It is possible to administer first a loading dose of 8 ml for at least 5 minutes, followed by an infusion of 20 ml of the drug diluted with a solution of 0.9% sodium chloride or 5% glucose for at least 6 hours, or first 8 ml for at least 30 minutes followed by infusion over at least 12 hours.
Convulsive syndrome. Adults: 5-10-20 ml intramuscularly. Children are administered intramuscularly at the rate of 0.08-0.16 ml/kg (20-40 mg/kg).
For eclampsia. 10-20 ml 1-2 times a day intramuscularly (can be combined with simultaneous administration neuroleptics).
For preeclampsia or eclampsia, it is administered intramuscularly or intravenously. First, 10 ml is injected once into each buttock or 16 ml (4 g of magnesium sulfate) intravenously over 3-4 minutes. Then continue to administer intramuscularly 16-20 ml (4-5 g) every 4 hours or intravenously drip 4-8 ml/hour (1-2 g/hour) with constant monitoring of tendon reflexes and respiratory function. Therapy is continued until the attack stops. The maximum daily dose is 40 g of magnesium sulfate, in case of impaired renal function - 20 g/48 hours.
Urinary retention. For urinary retention and lead colic, 5-10 ml of the drug is administered intramuscularly or 5-10 ml of a 25% solution of magnesium sulfate diluted 5 times (also prescribed as an enema).
Like an antidote. In case of intoxication with mercury, arsenic, tetraethyl lead, 5-10 ml of a 25% solution of magnesium sulfate diluted 2.5-5 times is administered intravenously. In case of poisoning with soluble barium salts, 4-8 ml are administered intravenously or the stomach is washed with a 1% solution of magnesium sulfate.
Newborns. For intracranial hypertension and severe asphyxia in newborns, it is administered intramuscularly, starting with a dose of 0.2 ml/kg/day, increasing the dose on the 3-4th day to 0.8 ml/kg/day for 3-8 days. complex therapy. To eliminate magnesium deficiency in newborns, 0.5-0.8 ml/kg is prescribed once a day for 5-8 days.
Arterial hypotension, bradycardia, palpitations, conduction disturbances, hot flashes, prolongation of the PQ interval and expansion of the QRS complex on the ECG, arrhythmia, coma, cardiac arrest
Dyspnea, respiratory depression
Headache, dizziness, general weakness, drowsiness, confusion, loss of consciousness, depressed mood, decreased tendon reflexes, diplopia, anxiety, speech disorders, tremors and numbness of the extremities
Nausea, vomiting, diarrhea
Anaphylactic shock, angioedema, hyperthermic syndrome, chills
Hyperemia, itching, rashes, urticaria, increased sweating
Polyuria
Uterine atony
Hypocalcemia, hypophosphatemia, hyperosmolar dehydration
Contraindications
Increased individual sensitivity to the components of the drug
Arterial hypotension, severe bradycardia (heart rate less than 55 beats/min), atrioventricular block
Conditions caused by calcium deficiency and depression of the respiratory center, serious illnesses respiratory organs
Cachexia
Impaired renal function, severe hepatic or renal failure
Myasthenia gravis
Prenatal period (2 hours before birth), lactation period
Menstruation
Use with caution for myasthenia gravis, respiratory diseases, acute inflammatory diseases of the gastrointestinal tract, and pregnancy.
Calcium ions have an antagonistic effect towards magnesium ions, which, when used simultaneously, leads to a decrease in the pharmacological effects of magnesium sulfate. Enhances the effect of drugs that depress the central nervous system (narcotics, analgesics). With the simultaneous use of muscle relaxants and nifedipine, neuromuscular blockade increases. Concomitant use with calcium channel blockers such as nifedipine may lead to calcium imbalance and impaired muscle function. Barbiturates, narcotic analgesics and antihypertensive drugs increase the likelihood of depression of the respiratory center.
Cardiac glycosides increase the risk of developing conduction disorders and atrioventricular block.
The effect of antithrombotic agents, vitamin K antagonists, isoniazid, and non-selective inhibitors of neuronal monoamine reuptake is reduced.
The elimination of mexiletine may be slower. Dosages may need to be revised.
Propafenone - the effect of both drugs is enhanced and the risk of toxic effects increases.
It interferes with the absorption of tetracycline antibiotics, intestinal obstruction is possible, and weakens the effect of streptomycin and tobramycin.
Pharmaceutically incompatible (precipitate forms) with calcium preparations, ethanol (in high concentrations), carbonates, bicarbonates and phosphates of alkali metals, salts of arsenic acid, barium, strontium, clindamycin phosphate, sodium hydrocortisone succinate, polymyxin B sulfate, procaine hydrochloride, salicylates and tartrates. At Mg2+ concentrations above 10 mmol/ml in total parenteral nutrition formulas, distribution of fat emulsions is possible.
Before starting therapy, the level of magnesium in the blood should be determined. In adults normal level magnesium in blood plasma is 0.75-1.26 mmol/l.
When using the drug, it should be taken into account that an increase in the excretion of magnesium in the urine occurs with an increase in extracellular fluid, dilation of the renal vessels, hypercalcemia, increased excretion of sodium in the urine, when prescribing osmotic diuretics (urea, mannitol, glucose), “loop” diuretics (furosemide, ethacrine acid, thiazides), when taking cardiac glycosides, calcitonin, thyroidin, with long-term administration of deoxycorticosterone acetate (more than 3-4 days). A slowdown in magnesium excretion is observed with the administration of parathyroid hormone. In renal failure, magnesium excretion slows down, and in repeated administrations its cumulation may occur. Therefore, in elderly patients and in patients with severe violation renal function, the dose of the drug should not be more than 20 g of magnesium sulfate (81 mmol Mg2+) within 48 hours; patients with oliguria or severe renal impairment should not administer magnesium sulfate intravenously quickly. Infections urinary tract accelerate the precipitation of ammonium-magnesium phosphates, and magnesium therapy is not temporarily recommended. If the excretion of magnesium is impaired after parenteral administration of magnesium sulfate, hypermagnesemia is possible.
Use with caution for myasthenia gravis and respiratory diseases. At long-term use drug monitoring is recommended of cardio-vascular system, tendon reflexes, kidney function and respiratory rate.
Intravenous administration Magnesium sulfate is administered slowly: if the rate of administration is too high, hypermagnesemia is possible (symptoms are nausea, paresthesia, sedation, hypoventilation up to apnea, decreased deep tendon reflexes). Simultaneous parenteral administration Vitamin B6 and insulin increase the effectiveness of magnesiotherapy.
If it is necessary to simultaneously administer magnesium sulfate and calcium preparations, they should be injected into different veins, and it must be taken into account that the level of magnesium depends on the level of calcium in the body.
The drug is used in pediatric practice.
Pregnancy, lactation period
Magnesium sulfate crosses the placenta, long-term therapy(more than 3 weeks) contributes to the leaching of calcium from the fetus.
During pregnancy, magnesium sulfate is used with caution, taking into account the concentration of magnesium in the blood, in cases where the expected therapeutic effect outweighs the potential risk to the fetus. When anesthetizing labor, one should take into account the possibility of inhibition of the contractility of the uterine muscles, which requires the use of birth stimulants.
Thank you
Magnesium sulfate is a medicinal product that contains active ingredients magnesium ions and sulfate group ions. Given Chemical substance has a wide range of effects on the human body. Magnesium sulfate has been used in medicine for a very long time, so all its effects are well studied and confirmed scientifically and empirically. Due to the numerous effects of magnesium sulfate, this substance is used as a symptomatic medicinal product with a huge number of different pathological conditions.
Magnesium sulfate has anticonvulsant, antiarrhythmic, vasodilator, hypotensive, antispasmodic, sedative, laxative, choleretic and tocolytic effects. That is why, when any condition occurs that magnesium sulfate can eliminate, it is used to relieve these symptoms. For example, magnesium sulfate will relieve cramps, relax the muscles of the uterus when there is a threat of miscarriage, lower blood pressure, etc.
Other names and recipe for magnesium sulfate
Magnesium sulfate has several common names that survive from earlier times and are still in use today. So, magnesium sulfate is called: - Epsom salt;
- Epsom salt;
- Magnesia;
- Magnesium sulfate;
- Magnesium sulfate heptahydrate.
A prescription for magnesium sulfate is written as follows:
Rp.: Sol. Magnesii sulfatis 25% 10.0 ml
D.t. d. No. 10 in amp.
S. administer 2 ml once a day.
In the recipe, after indicating the name in Latin “Magnesii sulfatis”, write the concentration of the solution - in in this example that's 25%. After which the volume is indicated, which in our example is 10 ml. After the designation "D. t. d." under the “No.” icon the number of ampoules with solution that need to be given to a person is indicated. In this example, the number of ampoules is 10. Finally, in the last line of the recipe after the designation "S." the dosage, frequency and method of use of the drug are indicated.
Group and release forms
Magnesium sulfate belongs to several pharmacological groups, according to the effect it provides:
1. Microelement;
2. Vasodilator;
3. Sedative (calming).
The medicinal substance was classified in several pharmacological groups, since magnesium sulfate has a huge number of therapeutic effects.
Today the drug is available in two dosage forms:
1.
Powder.
2.
Solution in ampoules.
The powder is available in packages of 10 g, 20 g, 25 g and 50 g. Magnesium sulfate in powder form is intended for dilution in water to obtain a suspension that can be taken orally. Magnesium sulfate solution is available in ampoules of 5 ml, 10 ml, 20 ml and 30 ml in two possible concentrations: 20% and 25%. This means that per 100 ml of solution there are, respectively, 20 g and 25 g of magnesium sulfate itself.
Magnesium sulfate powder and solution contains only this chemical. This means that there are no excipients in magnesium sulfate. That is, the drug is a simple chemical compound, which is the active component.
Therapeutic action and pharmacological properties
Magnesium sulfate has the following therapeutic properties:- anticonvulsant;
- antiarrhythmic;
- vasodilator;
- hypotensive (reduces blood pressure);
- antispasmodic (pain reliever);
- sedative (calming);
- laxative;
- choleretic;
- tocolytic (relaxes the uterus).
Yes, when ingestion in powder form, magnesium sulfate has a choleretic and laxative effect. The choleretic effect is achieved due to irritation of receptors duodenum. And the laxative effect is due to the fact that magnesium sulfate is not absorbed into the blood, but, on the contrary, increases the flow of water into the intestinal lumen, as a result of which the stool liquefies, increases in volume, and peristaltic movements reflexively increase. As a result of this, loosening of the stool occurs.
A small portion of magnesium sulfate that is absorbed into the blood is excreted by the kidneys. That is, indirectly, magnesium has a diuretic effect. In addition, it is recommended to take magnesium sulfate orally in case of poisoning with heavy metal salts, since in such cases the chemical compound plays the role of an antidote. The drug binds heavy metals and, thanks to its laxative effect, quickly removes them from the body.
The effect of magnesium sulfate after oral administration develops within 30 minutes - 3 hours, and lasts for at least 4 - 6 hours.
Magnesium sulfate solution is used by injection and topically. Locally, the solution is used to soak dressings and tampons on wound surfaces. Magnesia is also used for electrophoresis, which has a beneficial effect on the central nervous system and blood vessels. In addition, electrophoresis with magnesium effectively cures warts.
Intramuscular and intravenous injections Magnesium sulfate reduces blood pressure, has a calming effect, relieves convulsions, increases urination, dilates blood vessels and eliminates cardiac arrhythmias. High doses of magnesium sulfate, administered by injection, inhibit the activity of the central nervous system and have a tocolytic, hypnotic and narcotic effect. The mechanism of action of magnesium is due to the fact that magnesium is a competitor ion to calcium. As a result, after magnesium enters the body, it competitively displaces calcium from binding sites, which reduces the amount of acetylcholine, which is the main substance regulating vascular tone, smooth muscles and nerve impulse transmission.
The anticonvulsant effect of magnesium is due to the release of acetylcholine from the neuromuscular junction and the entry of magnesium ions into it. Magnesium ions inhibit signal transmission from nerve cells to muscles, which stops cramps. In addition, magnesium sulfate inhibits the functioning of the central nervous system, reducing the intensity of nerve impulses, which also reduces convulsive activity. Depending on the dosage, magnesium sulfate acts on the central nervous system as a hypnotic, sedative or analgesic.
The antiarrhythmic effect of magnesium sulfate is due to a decrease in general ability to the stimulation of cardiac muscle cells, as well as the normalization of the structure and functions of cardiomyocyte membranes. In addition, magnesium sulfate has protective effect on the heart, expanding coronary arteries and reducing the tendency to thrombosis.
The tocolytic effect is to relax the smooth muscles of the uterus in women, and stop them contractile activity. The muscles of the uterus relax and expand blood vessels, stops contractile activity, as a result of which the threat of abortion is eliminated.
Intravenous administration of magnesium sulfate provides an almost instant effect, lasting at least half an hour. And with intramuscular administration of magnesium, the effects develop within 1 hour and continue for 3 to 4 hours.
Indications for use
Due to its numerous pharmacological and therapeutic effects, magnesium sulfate has a wide range of indications for use. In some conditions, magnesium sulfate is indicated for use in the form of injections, while in other pathologies it must be taken orally. Indications for the use of magnesium sulfate orally and by injection are shown in the table:| Indications for use of magnesium sulfate orally (powder) | Indications for the use of magnesium sulfate in the form of injections (solution) |
| Cholangitis (inflammation of the bile duct) | Hypertensive crisis, including with cerebral edema |
| Poisoning | Myocardial infarction |
| Constipation | Eclampsia in pregnancy |
| Cholecystitis | Encephalopathy |
| Colon cleansing before upcoming medical procedures | Hypomagnesemia (for example, with unbalanced diet, taking contraceptives, diuretics, muscle relaxants, chronic alcoholism) |
| Duodenal intubation to obtain a cystic portion of bile | Increased need for magnesium (for example, during pregnancy, during adolescence, under stress, in the process of recovery) |
| Dyskinesia of the gallbladder of hypotonic type (for tubing) | As part of complex therapy for threatened miscarriage and premature birth |
| Cardiac arrhythmias | |
| Convulsions | |
| Tetany | |
| Angina pectoris | |
| Poisoning with salts of heavy metals, arsenic, tetraethyl lead, barium salts |
|
| As part of complex therapy of bronchial asthma | |
| Concussions | |
| Epileptic syndrome | |
| Urinary retention |
Magnesium sulfate (powder and solution) - instructions for use
Powder and solution have own characteristics in application, so we will consider them separately.Magnesium sulfate powder
The powder is used internally in the form of a suspension. Before use, the required amount of powder is dissolved in warm boiled water and stirred well. The product is used regardless of food intake. Magnesium sulfate is used as a choleretic agent as follows: dissolve 20–25 g of powder in 100 ml of warm boiled water. Take the resulting solution one tablespoon three times a day. To improve bile secretion, it is best to take magnesium sulfate before meals.
For duodenal intubation, prepare a solution as follows:
1.
10 g of powder is dissolved in 100 ml of water, obtaining a solution with a 10% concentration.
2.
12.5 g of powder is dissolved in 50 ml of water, obtaining a solution with a 25% concentration.
Then, 100 ml of a 10% or 50 ml of a 25% solution of magnesium sulfate is injected through a probe, with the help of which a bladder portion of bile is obtained. The solution administered through the probe must be warm.
An excellent remedy for this purpose is magnesium sulfate powder, or magnesia, which is a saline laxative. Magnesium sulfate acts quite gently, increasing the flow of water into the intestines, diluting stool and removing it out.
However, it should be remembered that the use of magnesium sulfate to cleanse the body is justified only before entering a diet, and not during the period of direct restriction on the quantity and quality of food consumed. You can use the drug in the first days of the diet, but not later. Magnesium sulfate will greatly facilitate entry into therapeutic fasting, eliminating toxins present in the body and thereby facilitating unpleasant symptoms the first days without food.
To cleanse the body before fasting or dieting for weight loss, magnesium sulfate can be used in two ways. In the first case, 30 g of powder is dissolved in half a glass of warm water and drunk before bed or any time half an hour before meals. In the second case, 30 g of powder is dissolved in half a glass of warm water and drunk in the morning, an hour after breakfast. The laxative effect develops within 4–6 hours after administration. This cleansing of the body should be carried out before entering a diet or fasting.
As an exception, you can take magnesium sulfate on the first day of a diet or fast. In this case, a person on a diet, after taking magnesium sulfate, should refrain from eating until the end of the current day. However, he will have to drink at least 2 liters of water.
Magnesium sulfate can only be used on the first day of the diet, or before entering a diet restriction regime. During a diet or fasting, you should not use magnesium sulfate to cleanse the body, as this can lead to diarrhea and dizziness, and also lead to loss of strength, vomiting, fainting, etc. Magnesium sulfate should not be used continuously, as this can lead to water-electrolyte imbalance and intestinal dysbiosis.
Magnesium sulfate for bath
Baths with magnesium sulfate have long been used as a physiotherapeutic method. A bath with magnesium will perfectly help relieve emotional and physical stress, pain, fatigue and nervousness, especially after flights, stress or anxiety. In the process of restoring balance in the body, you can take a bath with magnesium sulfate once a day, preferably before going to bed.In addition, a bath with magnesium sulfate has the following therapeutic effects:
- relieves spasm of small blood vessels;
- enhances microcirculation;
- increases uterine and renal blood flow;
- reduces blood pressure;
- reduces the formation of blood clots;
- relieves bronchospasm;
- prevents seizures in pregnant women and hypertension;
- eliminates cellulite;
- reduces muscle tone;
- enhances metabolic processes, promoting rapid recovery from injuries, fractures, serious illnesses, etc.
Tubage with magnesium sulfate
Tubage is a procedure for cleansing the liver and gallbladder. It is optimal to carry out tubing between 18 and 20 pm. Before the procedure, you should take 1 tablet of No-shpa, and prepare a solution for tubage at the rate of 30 g of magnesium sulfate powder per 100 ml of warm boiled water. You will need 0.5 - 1 liter of this solution. Then the actual tubing procedure with magnesium sulfate begins. Within 20 minutes, drink 0.5 - 1 liter of warm magnesium sulfate solution. After which the person should lie on his right side and place a heating pad on the liver area. Lie like this for 2 hours.
After tubage, a bitterness may appear in the mouth, which will go away on its own. Such tubages are made in courses of 10–16 procedures, which are carried out 1–2 times a week. Tubage should not be done in the acute stage of cholecystitis, and in the presence of erosions or ulcers in the gastrointestinal tract.
Magnesium sulfate for compresses
Magnesium sulfate can be used as a warm compress, which causes increased blood flow to the skin and underlying tissues. The main effects of a warm compress are pain relief and acceleration of the resorption of various seals. Warming compresses with magnesium sulfate are often applied to children at the DTP vaccination site.The compress is placed as follows:
1.
Roll the gauze into 6-8 layers.
2.
Wet gauze with a 25% solution of magnesium sulfate.
3.
Apply gauze to the injection site.
4.
Place thick paper on top for compresses.
5.
Cover the paper with cotton wool.
6.
Apply a bandage to keep the compress in place.
This compress is left for 6 - 8 hours, after which it is removed, the skin is washed with warm water, dried well with a towel and lubricated with a rich cream.
