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"Active ingredient of most natural laxative waters; used as a prompt acting cathartic in certain poisonings, in the treatment of increased intercranial pressure and oedema, as an anticonvulsant in eclampsia [when administered intravenously], and as an anti-inflammatory [when applied locally]." [Stedman's]
When injected in the dura mater spinalis, Magnesium sulphate acts as an anaesthetic, with a curare-like effect on the muscles, so that respiratory arrest can occur.
"It stands very close to Natrum sulphuricum. The soft stool soon after rising, diarrhoea which is striking by the massiveness of the stool, are just or even more characteristic for Nat-s." [Leeser]
The ancient reputation of Mag-s. as a "refrigerant cathartic" under the familiar name of "Epsom Salts," or "salts" par excellence, has overshadowed its homeopathic uses. But Mag-s. is something more than a "refrigerant cathartic." Recently old-school authorities have discovered in this "cathartic" a remedy for dysentery. It is the chief ingredient in many laxative mineral waters and popular saline aperient mixtures.
Mag-s. is of diagnostic and therapeutic value in Gallstone colic. The physiological dosage from 2 to 4 teaspoonfuls in glass hot water taken at onset of a colicky attack may abort or stop the colic.
Epsom salts is one of the most active saline cathartics, operating with little pain or nausea, especially if pure. It's action causing a rush of fluid into the intestine, which by producing a distention of the bowel produces evacuation. It causes little or no irritation in the intestine. In common with the other salines, it is the classical evacuant to be employed in connection with mercurials and anthelmintics and in cases of poisoning. Epsom salt usually acts within from one to two hours, more quickly if taken in hot water and in the morning before breakfast. The ordinary dose as a mild laxative is a heaping teaspoonful, as a cathartic, two to four teaspoonfuls.
The taste may be improved, if necessary, by the addition of a little lemon juice and sugar. Use on compresses saturated with solution. Besides its chief use as a saline cathartic, magnesium sulphate is used to a considerable extent externally in saturated solution as an antiphlogistic and anti-itching in erysipleas, ivy poisoning, cellulitis and other local inflammations.
Chest. 2005 Jul;128(1):337-44.
Aerosolized magnesium sulfate for acute asthma: a systematic review.
Blitz M, Blitz S, Hughes R, Diner B, Beasley R, Knopp J, Rowe BH.
Department of Emergency Medicine, 1G1.43 WMC, 8440-112 Street, Edmonton, Alberta, Canada T6G 2B7.
BACKGROUND: The use of MgSO(4) is one of numerous treatment options available during exacerbations of asthma. While the efficacy of therapy with IV MgSO(4) has been demonstrated, little is known about inhaled MgSO(4). OBJECTIVES: A systematic review of the literature was performed to examine the effect of inhaled MgSO(4) in the treatment of patients with asthma exacerbations in the emergency department. METHODS: Randomized controlled trials were eligible for inclusion and were identified from the Cochrane Airways Group "Asthma and Wheez*" register, which consists of a combined search of the EMBASE, CENTRAL, MEDLINE, and CINAHL databases and the manual searching of 20 key respiratory journals. Reference lists of published studies were searched, and a review of the gray literature was also performed. Studies were included if patients had been treated with nebulized MgSO(4) alone or in combination with beta(2)-agonists and were compared to the use of beta(2)-agonists alone or with an inactive control substance. Trial selection, data extraction, and methodological quality were assessed by two independent reviewers. The results from fixed-effects models are presented as standardized mean differences (SMDs) for pulmonary functions and the relative risks (RRs) for hospital admission. Both are displayed with their 95% confidence intervals (CIs). RESULTS: Six trials involving 296 patients were included. There was a significant difference in pulmonary function between patients whose treatments included nebulized MgSO(4) and those whose did not (SMD, 0.30; 95% CI, 0.05 to 0.55; five studies). There was a trend toward a reduced number of hospitalizations in patients whose treatments included nebulized MgSO(4) (RR, 0.67; 95% CI, 0.41 to 1.09; four studies). Subgroup analyses demonstrated that lung function improvement was similar in adult patients and in those patients who received nebulized MgSO(4) in addition to a beta(2)-agonist. CONCLUSIONS: The use of nebulized MgSO(4), particularly in addition to a beta(2)-agonist, in the treatment of an acute asthma exacerbation appears to produce benefits with respect to improved pulmonary function and may reduce the number of hospital admissions.
Heart. 2005 May;91(5):618-23.
Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis.
Miller S, Crystal E, Garfinkle M, Lau C, Lashevsky I, Connolly SJ.
Arrhythmia Services, Schulich Heart Centre, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
OBJECTIVES: To assess the efficacy of the administration of magnesium as a method for the prevention of postoperative atrial fibrillation (AF) and to evaluate its influence on hospital length of stay (LOS) and mortality. METHODS: Literature search and meta-analysis of the randomised control studies published since 1966. RESULTS: 20 randomised trials were identified, enrolling a total of 2490 patients. Study sample size varied between 20 and 400 patients. Magnesium administration decreased the proportion of patients developing postoperative AF from 28% in the control group to 18% in the treatment group (odds ratio 0.54, 95% confidence interval (CI) 0.38 to 0.75). Data on LOS were available from seven trials (1227 patients). Magnesium did not significantly affect LOS (weighted mean difference -0.07 days of stay, 95% CI -0.66 to 0.53). The overall mortality was low (0.7%) and was not affected by magnesium administration (odds ratio 1.22, 95% CI 0.39 to 3.77). CONCLUSION: Magnesium administration is an effective prophylactic measure for the prevention of postoperative AF. It does not significantly alter LOS or in-hospital mortality.
Ann Thorac Surg. 2005 Jan;79(1):117-26. Related Articles, Links
Three-day magnesium administration prevents atrial fibrillation after coronary artery bypass grafting.
Kohno H, Koyanagi T, Kasegawa H, Miyazaki M.
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. firstname.lastname@example.org
BACKGROUND: The efficacy of magnesium administration in preventing the occurrence of atrial fibrillation after coronary artery bypass grafting surgery remains controversial. Optimal dose and timing of the administration also await clarification. The purpose of this study was to assess the effect of 3-day postoperative infusion of magnesium on postoperative atrial fibrillation and to find factors that can influence the efficacy of this treatment. METHODS: After institutional review board approval, a retrospective study was conducted reviewing 200 consecutive patients who underwent isolated, initial coronary artery bypass grafting operation. The first 100 patients did not receive the prophylactic treatment, whereas the next 100 patients were treated with magnesium postoperatively. Patients in the magnesium-treated group received 10 mmol (2.47 g) of magnesium sulfate (MgSO4 * 7H2O) infused daily for 3 days after surgery. RESULTS: The incidence of postoperative atrial fibrillation was 35% in the untreated group compared with 16% in the magnesium-treated group (p = 0.002). Multivariate logistic regression analysis revealed that advanced age, decreased left ventricular ejection fraction, and absence of magnesium therapy were independent predictors of postoperative atrial fibrillation. For patients receiving the magnesium therapy, advanced age and decreased ejection fraction were the independent factors that predicted the arrhythmia. CONCLUSIONS: Postoperative 3-day magnesium infusion is effective in reducing the incidence of atrial fibrillation occurring after coronary artery bypass grafting surgery. However, in older patients or in patients with reduced left ventricular function, magnesium treatment alone is insufficient for prophylaxis of postoperative atrial fibrillation.
Rev Med Suisse. 2005 Jan 26;1(4):290, 292-5. Related Articles, Links
[Recent data on the physiopathology of preeclampsia and recommendations for treatment]
Landau R, Irion O.
Service d'Anesthesiologie, Departement APSIC, HUG, 1211 Geneve 4. email@example.com
Maternal hypertension and proteinuria after 20 weeks gestation defines preeclampsia. Severe preeclampsia is defined by severe hypertension or massive proteinuria, with or without symptoms or altered laboratory tests. With an incidence of 4-7%, preeclampsia remains a major cause of maternal and neonatal morbidity and mortality. Admission into a hospital is crucial to monitor both mother and fetus. The only treatment is delivery. Management of blood pressure and prevention of eclampsia with magnesium sulfate is indicated in severe preeclampsia. Despite numerous studies attempting to elucidate the exact etiopathogenesis of this complex multifactorial disease, prediction or prevention of preeclampsia is not available. Preeclampsia has been named the "disease of theories" and remains to date a challenging enigma for the scientific community.