Magnesia solution 5. Is Magnesia intramuscularly effective for pressure: dosage and nuances of injection
Magnesium sulfate
- magnesium sulphate heptahydrate
Composition and release form of the drug
Solution for intravenous administration in the form of a clear, colorless liquid.
Excipients: water for injection - up to 1 ml.
5 ml - colorless glass ampoules (10) - cardboard boxes.
5 ml - colorless glass ampoules (5) - contour cell packaging (1) - cardboard packs.
5 ml - colorless glass ampoules (5) - contour cell packaging (2) - cardboard packs.
10 ml - colorless glass ampoules (10) - cardboard boxes.
10 ml - colorless glass ampoules (5) - contour cell packaging (1) - cardboard packs.
10 ml - colorless glass ampoules (5) - contour cell packaging (2) - cardboard packs.
pharmachologic effect
When taken orally, it has a choleretic (reflex effect on the receptors of the duodenal mucosa) and action (due to poor absorption of the drug in the intestine, high osmotic pressure is created in it, water accumulates in the intestine, the intestinal contents are liquefied, peristalsis is enhanced). It is an antidote for poisoning with heavy metal salts. The onset of the effect is after 0.5-3 hours, duration is 4-6 hours.
When administered parenterally, it has a hypotensive, sedative and anticonvulsant effect, as well as a diuretic, arteriodilatating, antiarrhythmic, vasodilating (on arteries) effect, in high doses - curare-like (inhibitory effect on neuromuscular transmission), tocolytic, hypnotic and narcotic effects, suppresses respiratory center. Magnesium is a physiological blocker of slow calcium channels and is able to displace it from binding sites. Regulates metabolic processes, interneuronal transmission and muscle excitability, prevents the entry of calcium through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral nervous system and the central nervous system. Relaxes smooth muscles, reduces blood pressure (mostly elevated), increases diuresis.
The mechanism of anticonvulsant action is associated with a decrease in the release of acetylcholine from neuromuscular synapses, while magnesium suppresses neuromuscular transmission and has a direct inhibitory effect on the central nervous system.
The antiarrhythmic effect of magnesium is due to a decrease in the excitability of cardiomyocytes, restoration of ionic balance, stabilization of cell membranes, disruption of sodium current, slow incoming calcium current and one-way potassium current. The cardioprotective effect is due to the expansion of the coronary arteries, a decrease in peripheral vascular resistance and platelet aggregation.
The tocolytic effect develops as a result of inhibition of myometrial contractility (decreased absorption, binding and distribution of calcium in smooth muscle cells) under the influence of magnesium ion, increased blood flow in the uterus as a result of dilation of its vessels. Magnesium is an antidote for poisoning with heavy metal salts.
Systemic effects develop almost immediately after intravenous administration and 1 hour after intramuscular administration. Duration of action with intravenous administration is 30 minutes, with intramuscular administration - 3-4 hours.
Pharmacokinetics
After oral administration, no more than 20% of the dose taken is absorbed.
C ss, at which the anticonvulsant effect develops, is 2-3.5 mmol/l.
Penetrates the BBB and the placental barrier, excreted in breast milk at a concentration 2 times higher than the concentration in. Excreted by the kidneys, the rate of renal excretion is proportional to plasma concentration and glomerular filtration rate.
Indications
For oral administration: constipation, cholangitis, cholecystitis, hypotonic dyskinesia of the gallbladder (for tubing), duodenal intubation (to obtain a cystic portion of bile), bowel cleansing before diagnostic procedures.
For parenteral administration: arterial hypertension (including hypertensive crisis with symptoms of cerebral edema), hypomagnesemia (including increased need for magnesium and acute hypomagnesemia - tetany, impaired myocardial function), polymorphic ventricular tachycardia (pirouette type) ), urinary retention, encephalopathy, epileptic syndrome, threat of premature birth, convulsions during gestosis, eclampsia.
Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead, barium).
Contraindications
Severe chronic renal failure, hypersensitivity to magnesium sulfate.
For oral administration: appendicitis, rectal bleeding (including undiagnosed), intestinal obstruction, dehydration.
For parenteral administration: arterial hypotension, depression of the respiratory center, severe bradycardia, AV block, prenatal period (2 hours before birth).
Dosage
Individual, depending on the indications and dosage form used. Intended for oral administration, intramuscular and intravenous (slow) administration, administration through a duodenal tube.
Side effects
Early signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden flushing of the face, headache, decreased blood pressure, nausea, shortness of breath, slurred speech, vomiting, weakness.
Signs of hypermagnesemia(in order of increasing serum magnesium concentration): decreased deep tendon reflexes (2-3.5 mmol/l), prolongation of the PQ interval and widening of the QRS complex on the ECG (2.5-5 mmol/l), loss of deep tendon reflexes (4-5 mmol/l), depression of the respiratory center (5-6.5 mmol/l), cardiac conduction disturbance (7.5 mmol/l), cardiac arrest (12.5 mmol/l); in addition - hyperhidrosis, anxiety, severe sedation, polyuria, uterine atony.
When taken orally: nausea, vomiting, diarrhea, exacerbation of inflammatory diseases of the gastrointestinal tract, electrolyte imbalance (fatigue, asthenia, confusion, arrhythmia, convulsions), flatulence, spastic abdominal pain, thirst, signs of hypermagnesemia in the presence of renal failure (dizziness).
Drug interactions
With parenteral use of magnesium sulfate and simultaneous use of peripheral action, the effects of peripheral muscle relaxants are enhanced.
With simultaneous ingestion of antibiotics from the tetracycline group, the effect of tetracyclines may decrease due to a decrease in their absorption from the gastrointestinal tract.
A case of respiratory arrest during the use of gentamicin in an infant with an increased concentration of magnesium in the blood plasma during therapy with magnesium sulfate is described.
When used simultaneously with nifedipine, severe muscle weakness is possible.
Reduces the effectiveness of oral anticoagulants (including coumarin derivatives or indanedione derivatives), cardiac glycosides, phenothiazines (especially chlorpromazine). Reduces the absorption of ciprofloxacin, etidronic acid, weakens the effect of streptomycin and tobramycin.
Calcium preparations - or calcium gluconate - are used as an antidote for an overdose of magnesium sulfate.
Pharmaceutically incompatible (precipitate is formed) with calcium preparations, ethanol (in high concentrations), carbonates, bicarbonates and phosphates of alkali metals, salts of arsenic acid, barium, strontium, clindamycin phosphate, hydrocortisone sodium succinate, sulfate, procaine hydrochloride, salicylates and tartrates.
special instructions
Take orally or administer parenterally with caution in case of heart block, myocardial damage, chronic renal failure, respiratory diseases, acute inflammatory diseases of the gastrointestinal tract, pregnancy.
Magnesium sulfate can be used to relieve status epilepticus (as part of complex treatment).
In case of overdose, it causes depression of the central nervous system. Calcium preparations - calcium chloride or - are used as an antidote for an overdose of magnesium sulfate.
Pregnancy and lactation
During pregnancy, magnesium sulfate is used with caution, only in cases where the expected therapeutic effect outweighs the potential risk to the fetus.
If use is necessary during lactation, breastfeeding should be discontinued.
For impaired renal function
Contraindicated in severe chronic renal failure. Take orally or administer parenterally with caution in chronic renal failure.
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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
The drug Magnesia
Magnesium sulfate(Magnesia, magnesium sulfate, Epsom salt, etc.) includes magnesium salt of sulfuric acid. This drug does not contain any impurities or excipients.The effectiveness of this drug has long been proven, and the drug is successfully used in various branches of medicine (gynecology, neurology, gastroenterology and many others) due to the numerous effects it has.
Local application of Magnesia for dressings and compresses helps improve blood flow in the skin tissues and achieve an analgesic and absorbable effect.
Sports magnesium is used to dry hands. This ensures a reduction in the slipping of the athlete’s hands when gripping a particular sports apparatus or equipment.
Release form
Magnesia is available in various forms: 1. In ampoules of 10 ml - 25% solution (10 pcs. per package).
2. In ampoules of 5 ml - 25% solution (10 pieces per package).
3. Powder for preparing the suspension - in packages of 10, 20 and 25 g.
4. Powder, balls, briquettes of magnesium sulfate for athletes - various forms of release and packaging.
Instructions for use of Magnesia
Indications for use
- epilepsy;
- eclampsia;
- threat of premature birth;
- hypomagnesemia (magnesium deficiency in the blood);
- ventricular arrhythmias (including with low concentrations of potassium and magnesium in the blood);
- excessive nervous excitability (with epilepsy, increased mental and motor activity, convulsions);
- increased sweating;
- hypotonic biliary dyskinesia;
- duodenal intubation;
- heavy metal poisoning;
- constipation;
- urinary retention;
- treatment of warts;
- treatment of wounds and infiltrates.
Contraindications
- Arterial hypotension;
- atrioventricular block (impaired conduction of impulses from the atria to the ventricles);
- severe bradycardia;
- depression of the respiratory center;
- prenatal period;
- severe renal failure;
- rectal bleeding;
Side effects
- Depression of the heart;
- bradycardia;
- flushes of blood to the face;
- sweating;
- depression of the central nervous system;
- state of anxiety;
- confusion;
- polyuria;
- thirst;
- spasmodic pain.
Interaction with other drugs
When administered intravenously or intramuscularly with a solution of magnesium sulfate simultaneously with certain other medications, an increase or decrease in the effect of a particular drug may be observed:- when magnesia is combined with peripherally acting muscle relaxants, the effect of muscle relaxants is enhanced;
- with Nifedipine - severe muscle weakness may be provoked;
- with anticoagulants (oral), cardiac glycosides, phenothiazine - the effectiveness of the drugs decreases;
- with Ciprofloxacin – the antibacterial effect increases;
- with Tobramycin and Streptomycin - the antibacterial effect is reduced;
- with tetracycline antibiotics - the effectiveness of antibiotics decreases and their absorption from the gastrointestinal tract decreases.
- calcium;
- barium;
- strontium;
- arsenic salts;
- carbonates, phosphates and hydrocarbonates of alkali metals;
- procaine hydrochloride;
- tartrates;
- salicylates;
Treatment with magnesia
How is Magnesia taken orally?
To use Magnesia internally, a suspension is prepared from powder and warm boiled water. The dosage of magnesium sulfate when taking this drug orally depends on the indications and age of the patient. If Magnesia is used as a choleretic agent , it is used as follows:
- 20-25 g of powder is dissolved in 100 ml of warm boiled water;
- Before taking, stir the solution and immediately drink 1 tablespoon of the medicine;
- The solution must be taken before meals 3 times a day.
As a laxative:
- for adults and children over 14 years of age, a solution is prepared from 10-30 g of magnesium sulfate powder (the powder is diluted in 100 ml of warm boiled water);
- the resulting solution is taken at night or in the morning before meals;
- To speed up the laxative effect, you can take an additional large amount of warm boiled water (in this case, loosening of the stool will occur within 1-3 hours).
In some cases, to combat chronic constipation, medicinal enemas with a solution of magnesium sulfate (20-30 g per 100 ml of water) may be prescribed.
Intravenous and intramuscular administration of Magnesia
When using Magnesia as an anticonvulsant, antihypertensive, antiarrhythmic agent, the drug is administered intramuscularly or intravenously.
For intramuscular administration, a 25% solution is used, produced in ampoules, which does not require additional dilution. When administering this drug intravenously, the ampoule solution can be administered undiluted, or diluted with a solution of sodium chloride or 5% glucose.
Usually, for intravenous use, Magnesia solution is diluted, since rapid simultaneous administration in undiluted form can provoke a number of complications.
Intramuscular administration of Magnesia is accompanied by painful sensations.
Before administering an injection or drip, the nurse must warn the patient that if a number of symptoms appear (dizziness, headache, flushing of the face, decreased heartbeat), it is necessary to immediately report them to the doctor. The drip infusion itself may be accompanied by a slight burning sensation along the vein, which gradually stops. At the end of the drip infusion, a control measurement of pressure and pulse is carried out.
Magnesia dosage
When taken orally, the highest single dose of Magnesia is 30 g.
The maximum daily dose of Magnesia for intravenous or intramuscular administration is 200 ml of a 20% solution.
Magnesia for children
Quite often, Magnesia is used to treat constipation in children. For these purposes, the powder of the drug is used, which is diluted in 100 ml of warm boiled water. The dosage depends on the age of the child:- 6-12 years – 6-10 g per day;
- 12-15 years – 10 g per day;
- over 15 years old – 10-30 g per day.
For constipation in children, magnesium sulfate can also be used in the form of medicinal enemas. For an enema, you need to prepare a solution of 20-30 g of powder and 100 ml of warm boiled water. The amount of solution for administration into the rectum, depending on the age of the child, is 50-100 ml.
Magnesia is prescribed intravenously or intramuscularly to children only for relief of emergency conditions (severe asphyxia or intracranial hypertension). In these cases, intravenous or intramuscular administration of Magnesia is used even for newborns.
Magnesia during pregnancy
Magnesia during pregnancy is most often used to relieve hypertonicity of the uterus (relaxation of its smooth muscles). These measures become necessary in conditions such as threatened miscarriage or premature birth.In such cases, intravenous or intramuscular administration of Magnesia is used in a hospital setting, under the constant supervision of medical personnel. This is explained by the fact that when administered intravenously, this drug enters not only the mother’s blood, but also, passing through the placental barrier, enters the fetal blood. Thus, Magnesia can cause respiratory depression and a sharp decrease in blood pressure in the fetus. Due to the possible development of such complications, stop using Magnesia solution 2 hours before the expected birth.
Due to its diuretic effect, Magnesia can be used during pregnancy to reduce edema (for example, in preeclampsia and eclampsia). In this case, a solution of magnesium sulfate is introduced dropwise, slowly. To avoid complications, the doctor monitors the dynamics of pressure, respiratory rate, concentration of magnesium ions in the blood and tendon reflexes.
Tubazhi with Magnesia
Tubage with Magnesia improves the movement of bile through the bile ducts and can be an excellent prevention of cholelithiasis. This procedure can be carried out in a medical facility or, as prescribed by a doctor, at home. Indications for tubing:
- bile duct dyskinesia;
- stagnation of bile in the gallbladder.
Contraindications:
- cholelithiasis;
- rectal bleeding;
- intestinal obstruction;
- dehydration of the body;
- tendency to hypotension;
- attack of appendicitis;
- high levels of magnesium in the blood;
- exacerbation of any chronic disease;
Before the procedure, it is advisable to follow a gentle diet, which should be followed on the day of the procedure. You should avoid spices, smoked, pickled and salty foods. The diet can include various porridges (except millet, pearl barley and semolina) and dishes from boiled or baked vegetables.
Procedure:
1.
Stir 1 tablespoon of Magnesia powder in 250 ml of warm boiled water (you can use purified drinking water heated to 40 degrees or alkaline mineral water without gas).
2.
Drink the prepared mixture.
3.
Lie on your right side.
4.
Apply a heating pad or a bottle of warm water to the liver area.
5.
Lay down for about 1.5 hours.
The effectiveness of the tube can be determined by the color of the stool. The procedure is considered successful if the first stool excreted has a greenish tint. If there is no stool, constipation should be eliminated and the tubage procedure with Magnesia should be performed again.
After completing the tubage procedure, it is advisable to eat a salad made from grated boiled beets, seasoned with vegetable oil, or from grated raw carrots and apples.
Magnesia for colon cleansing
Colon cleansing with Magnesia can be carried out not only to eliminate constipation, but also to remove toxins accumulated on the intestinal walls from the body. This technique guarantees bowel cleansing and, when performed correctly, is considered safe. The procedure can be performed both in hospital and at home in the absence of contraindications to it. To carry it out, a medicinal enema is performed from dry Magnesia powder and warm boiled water. 20-30 g of dry powder are dissolved in 100 ml of warm boiled water. The resulting solution is injected into the intestinal lumen and causes swelling of the feces. Within 1-1.5 hours, toxins accumulated on the intestinal walls are removed from the body along with feces.
Such enemas are performed in one course, and their number is determined by the doctor. In recent years, there have been many opponents of such intestinal cleansing among doctors, who point to a number of possible complications. Other experts, on the contrary, advocate the advisability of such cleansing procedures, but recommend carrying them out only after consultation with a doctor.
Magnesia in physiotherapy
Magnesia is used for some physiotherapeutic procedures:- compresses - a 25% solution is used, the compress is applied to the desired area for 6-8 hours, then the skin is washed with warm water and lubricated with a rich cream (since magnesium sulfate has a drying property);
- electrophoresis - can be performed using different methods; a 20-25% solution is used to carry it out;
- medicinal baths - dry magnesium sulfate powder is used, which is dissolved in water; The water level in the bath should not reach the level of the heart.
The purpose of electrophoresis with Magnesia is more extensive. Under the influence of electrodes, a solution of magnesium sulfate penetrates into the deep layers of the skin and blood vessels, which helps normalize the psycho-emotional background, blood circulation and muscle condition. The duration of the procedure depends on the indications, health status and age of the patient.
Therapeutic baths with Magnesia are used not only to relieve physical and psycho-emotional stress, but can also be used to provide the following therapeutic effects:
- decreased blood pressure;
- increased blood microcirculation;
- elimination of spasms of small bronchi;
- prevention of seizures in pregnant women;
- increased blood circulation in the genitourinary organs;
- muscle relaxation;
- strengthening metabolic processes;
- recovery after serious illnesses and injuries.
Magnesia for weight loss
Losing weight with the help of Magnesia is becoming quite popular among those who are trying to lose excess weight. For this purpose, it is used internally (as a laxative) and in the form of baths. According to the recommendations of this weight loss technique, Magnesia should be taken orally to activate digestive processes and regularly loosen stools. The drug is prepared in the same way as to provide a laxative effect.
To prepare baths, use a mixture of Magnesia with table salt and Dead Sea salt. Before preparing the solution, approximately 100 liters of water (about 40 o C) are taken into the bath, in which a mixture of salts is dissolved.
Composition of the bath salt mixture:
- 4 packages of 25 g of Magnesia;
- 500 g table salt;
- 500 g Dead Sea salt.
The bath has a beneficial effect on the skin and the body as a whole: it helps remove excess fluid from subcutaneous fat, normalizes metabolism and psycho-emotional state. In addition, toxins are removed from the upper layers of the skin along with sweat.
It is possible to lose weight with the help of such baths, but only if you follow a rational diet and sufficient physical activity.
"Magnesia" is natural, it has a high level of magnesium ions and bicarbonates. That is why it is recommended for use in the treatment of diseases associated with magnesium deficiency in the body. Magnesium mineral waters are recommended for the treatment of:
These properties of magnesium sulfate are actively used by athletes, climbers and people in certain professions. In recent years, for ease of use, products have begun to be produced in the form of balls or briquettes, which are made from compressed Magnesia. When crushed, they turn into a powdery state.
Plasma replacement and perfusion solutions. Additives to solutions for intravenous administration. Electrolyte solutions. Magnesium sulfate.
ATX code B05XA05
Pharmacological properties
Pharmacokinetics
Equilibrium concentration (СSS) - 2-3.5 mmol/l. Penetrates the blood-brain and placental barriers, creating concentrations in breast milk that are 2 times higher than plasma concentrations.
Excretion is carried out by the kidneys, the rate of renal excretion is proportional to the plasma concentration and the level of glomerular filtration.
Pharmacodynamics
When administered parenterally, it has anticonvulsant, antiarrhythmic, hypotensive, antispasmodic effects; in large doses, it inhibits neuromuscular transmission, has a tocolytic effect, and suppresses the respiratory center.
Magnesium is a “physiological” blocker of “slow” calcium channels and is able to displace it from binding sites. Regulates metabolic processes, interneuron 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 (CNS). Relaxes smooth muscles, reduces blood pressure (BP) (mostly elevated), increases diuresis.
Anticonvulsant effect - magnesium reduces the release of acetylcholine from neuromuscular synapses, while suppressing neuromuscular transmission, and has a direct inhibitory effect on the central nervous system.
Antiarrhythmic effect - magnesium reduces the excitability of cardiomyocytes, restores ionic balance, stabilizes cell membranes, disrupts sodium flow, slow incoming calcium flow and one-way potassium flow.
The cardioprotective effect is due to the expansion of the coronary arteries, a decrease in total peripheral vascular resistance and platelet aggregation.
Tocolytic effect - magnesium inhibits the contractility of the myometrium (reducing the absorption, binding and distribution of calcium in smooth muscle cells), increases blood flow in the uterus as a result of dilatation of its vessels.
It is an antidote for poisoning with heavy metal salts.
Systemic effects develop almost immediately after intravenous (IV) administration. Duration of action with intravenous administration is 30 minutes.
Indications for use
Arterial hypertension (including hypertensive crisis with symptoms of cerebral edema)
Polymorphic ventricular tachycardia (pirouette type)
Convulsive syndrome (to suppress seizures in eclampsia; to prevent seizures in severe preeclampsia)
Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead)
Hypomagnesemia (including increased need for magnesium).
Directions for use and doses
Prescribed intravenously slowly or as an intravenous infusion.
When administered intravenously, the patient should be in a supine position.
Doses are adjusted taking into account the therapeutic effect and the concentration of magnesium ions in the blood serum.
The duration of treatment is determined by the doctor individually depending on the clinical situation. 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. The dose of the drug should be reduced if renal function is impaired.
No dose adjustment is required in elderly patients.
However, caution should be exercised if renal function is impaired.
Preeclampsia and eclampsia. The dose is set individually depending on the clinical situation. Saturation dose – 2-4 g over 5-20 minutes (infusion). Maintenance dose – 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 30-40 g of magnesium sulfate, in case of impaired renal function - 20 g/48 hours.
Hypomagnesemia
In newborns. To eliminate magnesium deficiency in newborns, 0.5-0.8 ml/kg is prescribed once a day for 5-8 days. It is not recommended to administer magnesium preparations intravenously to newborns due to the possibility of developing hypermagnesemia with respiratory arrest, cardiac arrest and arterial hypotension.
In adults.
Severe hypomagnesemia. The initial dose is 5 g. The dose is poured into 1 liter of infusion solution (0.9% sodium chloride solution or 5% glucose) and administered intravenously for at least 3 hours. Dosage depends on the concentration of the drug in the blood serum.
The maximum daily dose for intravenous administration is 72 ml (18 g).
Prevention of hypomagnesemia in patients receiving only parenteral nutrition. If there is no magnesium in the nutrient solutions, it is added additionally. The daily dose is 1.5-4 g. Typically, 1 g of magnesium sulfate is added to 1 liter of parenteral nutrition solution.
During a hypertensive crisis, 5-20 ml of a 25% solution of magnesium sulfate is administered intravenously (slowly!!).
To relieve arrhythmias, 1-2 g are administered intravenously over about 5 minutes, repeated administration is possible (total administration of up to 4 g of magnesium sulfate).
Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead)
As an antidote, magnesium sulfate is used intravenously in a stream of 5 ml of a 25% solution.
Doses of Magnesium sulfate are indicated in grams.
They correspond to the amount of solution: 1 g – 4 ml (25%); 2 g – 8 ml (25%);
3 g–12 ml (25%); 4 g–16 ml (25%); 5 g – 20 ml (25%); 10 g – 40 ml (25%); 15 g –60 ml (25%); 20 g – 80 ml (25%); 30 g –120 ml (25%); 40 g – 160 ml (25%).
A solution of magnesium sulfate in ampoules is diluted with injection solutions: 0.9% sodium chloride solution or 5% dextrose (glucose). Freshly prepared infusion solutions cannot be stored for long periods of time and should be used immediately after preparation.
Side effects
The incidence of these side effects has not been established.
From the respiratory system: slow breathing rate, shortness of breath;
From the cardiovascular system: acute circulatory failure, arterial hypotension, decreased heart rate, palpitations.
From the nervous system: weakened reflexes, decreased muscle tone, anxiety, severe sedation, dizziness, loss of consciousness, depressed mood, flaccid paralysis.
Magnesium sulfate reduces the excitability of the respiratory center; large doses of magnesium sulfate when administered parenterally can cause paralysis of the respiratory center.
From the skin: skin hyperemia, itching, rashes, urticaria.
From the immune system: anaphylactic shock, angioedema, hyperthermic syndrome, chills.
From the gastrointestinal tract: nausea, vomiting, diarrhea.
From the urinary system: polyuria.
From the reproductive system: uterine atony.
General disorders: hypothermia; hyperhidrosis.
Hypermagnesemia
Signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden rush of blood to the face, thirst, headache, decreased blood pressure, nausea, shortness of breath, slurred speech, vomiting, general weakness, drowsiness, confusion, loss of tendon reflexes due to nervous muscle blockade, respiratory depression, water and electrolyte imbalance (hypocalcemia, hypophosphatemia, hyperosmolar dehydration), ECG changes (prolongation of PR, QRS and QT intervals), cardiac arrhythmia, coma and cardiac arrest.
Signs of hypermagnesemia, ranked in order of increasing concentration of magnesium ions in the blood serum: decreased deep tendon reflexes (2–3.5 mmol/l), prolongation of the PQ interval and widening of the QRS complex on the electrocardiogram (2.5–5 mmol/l), decreased tendon reflexes (4–5 mmol/l), depression of the respiratory center (5–6.5 mmol/l), cardiac conduction disturbance (7.5 mmol/l), cardiac arrest (12.5 mmol/l).
Contraindications
Hypersensitivity to the drug
Atrioventricular block I-III degree (AV block)
Severe renal failure (creatinine clearance less than 20 ml/min)
Severe hypotension
Conditions associated with calcium deficiency and depression of the respiratory center
Bradycardia
Prenatal period (2 hours before birth)
Conditions caused by calcium deficiency and depression of the respiratory center, severe respiratory diseases
Cachexia
Severe liver failure
Myasthenia gravis
Malignant neoplasms
Menstruation
Lactation period
With caution: chronic renal failure, respiratory diseases, acute inflammatory diseases of the gastrointestinal tract, old age, pregnancy, childhood.
Drug interactions
Patients who use other medications along with magnesium sulfate should inform their doctor about this.
Enhances the effect of other drugs that depress the central nervous system.
Cardiac glycosides increase the risk of conduction disturbances and atrioventricular block (especially with simultaneous intravenous administration of calcium salts).
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.
Muscle relaxants and nifedipine enhance neuromuscular blockade.
When combined with magnesium sulfate for parenteral administration with other vasodilators, the hypotensive effect may be enhanced.
Barbiturates, narcotic analgesics, and antihypertensive drugs increase the likelihood of depression of the respiratory center.
It interferes with the absorption of tetracycline antibiotics and weakens the effect of streptomycin and tobramycin.
Calcium salts reduce the effect of magnesium sulfate.
Pharmaceutically incompatible (forms a precipitate) with calcium preparations, carbonates, bicarbonates and alkali metal phosphates, clindamycin phosphate, hydrocortisone sodium succinate, polymyxin B sulfate, procaine hydrochloride, salicylates and tartrates.
At concentrations of magnesium ions above 10 mmol/ml in total parenteral nutrition mixtures, separation of fat emulsions is possible.
special instructions
Magnesium sulfate should be used carefully to avoid toxic concentrations of magnesium sulfate. Before starting therapy, the level of magnesium in the blood should be determined. In adults, the normal level of 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 case of renal failure, the excretion of magnesium slows down, and with repeated administrations, its accumulation may occur.
Elderly people should usually use a reduced dose because they have reduced kidney function. Patients with impaired renal function (if creatinine clearance is more than 20 ml/min) and oliguria should not receive more than 20 g of magnesium sulfate (81 mmol Mg2+) within 48 hours, and magnesium sulfate should not be administered intravenously too quickly. It is recommended to monitor the concentration of magnesium ions in the blood serum (should not be higher than 0.8–1.2 mmol/l), diuresis (at least 100 ml/h), respiratory rate (at least 16/min), control of tendon reflexes and blood pressure .
Urinary tract infections accelerate the precipitation of ammonium magnesium phosphates, and magnesium therapy is temporarily not recommended. If the excretion of magnesium is impaired after parenteral administration of magnesium sulfate, hypermagnesemia is possible.
Use with caution for respiratory diseases. With long-term use of the drug, monitoring of the cardiovascular system, tendon reflexes, renal function and respiratory rate is recommended.
Intravenous administration of magnesium sulfate is carried out slowly: if the rate of administration is too high, hypermagnesemia is possible. Simultaneous parenteral administration of vitamin B6 and insulin increases the effectiveness of magnesium therapy.
Marina Maksimova
Magnesia in ampoules, instructions for use indicate suitability for various fields of medicine. This is a laxative approved for children and pregnant women.
Prescribed for magnesium deficiency, as an important trace element to support the functionality of many systems and organs. Sold in ampoules, administration intramuscularly, intravenously.
It is important to consider the dosage and follow the instructions for use. There are side effects and contraindications.
Composition, release form and packaging
Magnesia (sulfuric acid salt) is a chemical compound. Found naturally in seawater. Release form: whitish dry powder (briquettes) by dissolving with water.
Packing – 5,10,25 g for oral use, ampoules (5.10 ml) for injection.
Contains:
- active magnesium salt of sulfuric acid;
- auxiliary component – purified injection water.
It is possible to add other impurities. Products with magnesium may contain different percentages of the active salt.
Latin name of the drug- Magnesium sulfate.
Manufacturers: pharmaceutical factories - Kaliningrad, Ivanovo, St. Petersburg, Pyatigorsk, chemical farm Belarus, Borisov pharmaceutical plant.
pharmachologic effect
The medicine has a choleretic effect on the receptors of the duodenum, providing a laxative effect. Intestinal absorption is quite low, but osmotic pressure increases, feces become thinner, and peristalsis normalizes.
Magnesium sulfate with sulfuric acid, magnesium salt has a positive effect on the body, solves many health problems, promotes:
- vasodilation;
- providing analgesic, antispasmodic, diuretic, antiarrhythmic effect;
- weakening of the smooth muscles of the uterus;
- expulsion of bile from the intestines;
- weakening of peristalsis, stool, and neuromuscular muscles;
- liquefaction of feces.
Use in large doses can have a narcotic, hypnotic effect.
Calcium channel blocker - magnesium sulfate, displacing stagnation from the connecting areas, regulates metabolism and muscle excitability, prevents the flow of calcium through the intestinal membranes, relieving muscle cramps.
This is how acetylcholine is quickly released from synapses in muscles.
When administered intravenously after 0.5-1 hour, a rapid systemic effect is observed. Absorption of the drug by the kidneys is up to 20%. The rate of excretion is directly proportional to the degree of glomerular infiltration.
Magnesia quickly passes into breast milk, also through the blood-brain barrier. The percentage can be 2 times higher than in the blood.
Even with one-time use, the medicine helps to weaken smooth muscles, lowering blood pressure, increasing diuresis, providing an anticonvulsant, antiarrhythmic effect. Lead to a decrease in the excitability of cardiomyocytes.
Indications for use
The medication is prescribed for the treatment of many problems in women, it helps:
- relieving muscle cramps;
- normalization of heart functions;
- acceleration of metabolism.
Main indications for use:
- cholangitis;
- cystic seizures;
- risk of miscarriage;
- premature birth;
- biliary dyskinesia (tubage);
- gestosis;
- urinary retention;
- barium poisoning;
- bowel cleansing on the eve of surgery;
- hypotonic crisis with swelling of the brain;
- eclampsia.
Parenteral administration of magnesium promotes:
- providing a calming effect;
- relieving seizures and signs of arrhythmia;
- regulation of metabolic processes;
- decrease in blood pressure;
- smoothing muscle tissue.
Magnesia can be used to replenish the body with magnesium for the prevention and treatment of arrhythmia, to improve the effectiveness of anesthesia, and to eliminate toxicosis during pregnancy in the 2-3 trimester.
Contraindications for use
Main contraindications:
Instructions for use and dosage regimen
Instructions for use depending on the disease:
- If you are concerned about spasm, convulsive syndrome, hypertension, eclampsia, then magnesium ampoules (25%) are used intravenously, intramuscularly 20 ml once, and so on up to 4 times a day.
- To stop seizures in babies, 0.2 ml per 1 kg of weight (20%) solution is injected. For acute poisoning, the average dose is 10 ml. Used as a choleretic composition - 20 g per 100 g of water, 3 times a day, preferably food.
- If you need to relieve signs of poisoning with heavy metal salts, then the use of magnesium is internal, 25 g per 1 glass of water.
- Often the medicine is prescribed before the procedure. duodenal intubation with a dosage of 150 ml (25% solution).
The best form of medicine as a laxative is powder. The permissible dose is 25-30 g by diluting with water (100 ml), drinking at night (in the morning) on an empty stomach.
An enema is given if constipation is a concern by adding 100 ml of water to the powder to provide a laxative effect.
Reference! This remedy can be used episodicly or as a long-term treatment.
Features of application
Each form of this medicine has certain features for use. It is recommended to read the instructions before use.
For children and pregnant women, the dosage and course of treatment are selected directly by the attending physician, taking into account the existing problem, weight, age, and diagnostic indications.
- If you need to use the medication as a laxative, then the permissible dose is 30 g per 100 ml of water.
- As a choleretic agent during a hypertension crisis up to 20 ml is administered.
- It is better to give a suspension to children. The permissible dosage is 20 g and washed down with water (0.5 cups) 3 times.
- Magnesia in injections is used to relieve unpleasant symptoms of the disease. Prescribed for intravenous administration. Concentration - 25% with a duration of infusion of the composition of 40-45 minutes.
- For poisoning, hypertensive crisis, convulsive syndrome– intravenous administration (10% solution), eclampsia – 20 ml (25% solution) up to 4:00 times a day.
- It is possible to inject magnesium in combination with painkillers.
Pills
The drug in tablets containing active ingredients and vitamins (B1, B3) is used to compensate for the lack of magnesium. The recommended dose is 340 mg 2 times a day.
Purpose of the tablet form of magnesia:
- convulsions;
- heart problems;
- nervous tension;
- stress;
- spasms of smooth muscles.
Suspension
The use of magnesia in the form of a suspension with laxative properties is permissible for children in case of poisoning, to dilute stagnant feces in case of impaired peristalsis in order to quickly bind magnesium sulfate with toxic substances (barium, lead, mercury, arsenic) and remove it from the body.
- To relieve VSD attacks, it is possible to administer intravenous or intramuscular injections. Results can be expected after 10-20 minutes and last up to 2-3 hours.
- Adults with convulsive syndrome, hypertensive crisis 25% of the drug is administered slowly, for children with convulsions - no more than 0.3 ml per 1 kg of weight by administering a 20% solution intramuscularly.
- For acute poisoning, constipation, biliary dyskinesia an acceptable dose is powder diluted with water (20 g per 100 ml). Adults are allowed to drink up to 30 mg once at night or on an empty stomach.
Reference! It is not recommended to carry out procedures more than once a month without a doctor’s prescription. When using magnesia as an enema to relieve peristalsis or in case of poisoning, the dosage should not exceed 20 g per 100 ml of water once a day.
Tubazhi with magnesia
Tubazh- flushing of the bile ducts.
In combination with magnesium, it helps to increase the passage of bile through the bile ducts, eliminate congestion, and prevent the formation of stones in the bladder.
A similar procedure is carried out in a medical institution or at home independently, but as prescribed by the treating specialist after an examination for indications for use:
- bile obstruction in the duodenum;
- bile duct dyskinesia;
- retention of bile in the gallbladder.
Restrictions on the use of tubage are required when:
- intestinal colic, obstruction;
- dehydration;
- low pressure;
- excessive concentration of magnesium in the blood;
- chronic internal diseases.
Carrying out tubage involves the use of magnesia (mixture) + boiled water. The course of treatment is 1 time every 7 days. An acceptable course is up to 15 weeks. Before tubage, patients need to go on a diet, exclude marinades, saltiness, seasonings, and smoked foods from the diet. You can only eat porridge and baked vegetables (fruits).
The tubage procedure is as follows:
- dissolve magnesia (1 tbsp) in boiling water (250 ml), non-carbonated mineral water;
- refill the enema;
- lie on your right side;
- apply a bottle of warm water (a heating pad) to the area (where the liver is);
- calm down, lie down for a while;
- administer an enema;
- wait 1.5 hours to achieve positive results, which can be seen by the color of the stool after the first bowel movement.
First, a green color will begin to appear, which means the procedure was successful. If new problems with emptying arise, the procedure can be repeated, but following the attached instructions for use of magnesium.
After the end of the tube, do not neglect your diet. Immediately have a snack with a salad of raw carrots (apple), seasoned with sunflower oil.
Tubazh is prescribed for stagnation of bile, dyskinesia of the biliary tract. Contraindications: intestinal obstruction, appendicitis, dehydration.
Use for colon cleansing
Today, magnesium for intestinal cleansing is often prescribed by doctors, but you can do it yourself at home after examination and consultation with a specialist.
The method is suitable for cleansing the intestines by introducing magnesium sulfate, no more than once a month to avoid irritation of the mucous membrane. It is enough to carry out 2-3 procedures to eliminate constipation and normalize intestinal motility.
Many people experience difficulties with bowel movements when fecal particles accumulate in the walls of the rectum and colon, preventing the natural passage of feces out. In this case, toxic substances begin to flow throughout the body.
To soften the stones and eliminate this problem, it is worth performing an enema. Take magnesia powder (30 g), dissolve in boiling water (1 glass), insert into the anus. The effect is observed after 1 hour, when toxins begin to leave the intestines along with the stool.
Reference! You should not give enemas with magnesium frequently without a doctor’s prescription. There may be no side effects, but do not neglect possible contraindications. In addition, the procedure for cleaning the intestines with magnesium is not suitable for everyone.
Magnesia in physiotherapy
- Magnesium sulfate is useful for dilating blood vessels. Prescribed by a doctor during physiotherapeutic procedures as an antiarrhythmic drug by intramuscular injection to relieve spasms and dilate blood vessels.
- Magnesium sulfate helps in the treatment of papillomas, warts when applied externally by applying compresses of diluted powder with water. So it is enough to dilute 20 g of dry powder in 1 liter of water, moisten a gauze cloth, and apply it to the affected areas.
- It is recommended to carry out procedures 2 times a day. The course of treatment is 3 weeks. Warts and papillomas will gradually begin to dry out and fall off.
- Magnesia goes well with electrophoresis. Used in the treatment of dermatovenerological diseases. The treatment regimen and dosage are selected only by the attending physiotherapist.
Using magnesium for weight loss
Magnesium is not the best medicine if you want to lose weight.
However, it can be added to baths or taken orally in powder form to empty the bowels and enhance digestive processes.
The mixture is made in the same proportions as for the treatment of constipation.
To add magnesia powder to the bath, mix it with salt (sea, ordinary) and add to warm water.
This has a good effect on the condition of the skin, expels toxins from the body, and improves mood.
Recipe:
- Mix 4 bags of dry magnesia with salt (0.5 g);
- pour into hot water (T-40-45 g);
- take baths for up to 20-30 minutes, and so on up to 3 times a week.
On a note! This method cannot be called effective in the fight against extra pounds. Additionally, you need to do physical exercise, follow a diet, and also take into account contraindications (oncology, infectious process, hypothyroidism, diabetes mellitus, epilepsy, chronic diseases during exacerbation, heart failure).
According to many patients, this is an emergency method for losing weight. It is better to choose other alternative options.
Side effects
If you neglect the instructions for using magnesia and overestimate the dose, there may be cases of overdose and side effects:
When magnesium sulfate in the blood reaches over 12 mol/l Premature cardiac arrest is possible due to the intense effect of the active component on the central nervous system. Severe thirst, sweating, bradycardia, and confusion may occur.
If the blood norm exceeds 5 mol/l Blood pressure drops sharply, confusion of speech, hyperhidrosis, nausea, loss of strength, and vomiting are observed. In some cases, it is impossible to do without taking emergency measures to eliminate the side effects of magnesia: hemodialysis, artificial ventilation.
Use during pregnancy and breastfeeding
Magnesium sulfate is often prescribed to pregnant women, although the effect is significantly higher than the possible risks to the fetus. Magnesia is used to prevent miscarriage and premature birth.
Helps eliminate uterine hypertonicity. However, overdoses are excluded. The medicine is prescribed exclusively by the attending physician, gestosis, severe edema.
The permissible dosage for pregnant women is 520 mg by intravenous administration (25% solution) in injections per 1 liter of solution with slow administration.
Attention! This medicine has a pronounced diuretic effect. Requires careful use and only when checking diastolic pressure with a norm of 100x130 mm/Hg/st.
Magnesium therapy is prescribed to women after childbirth 1-2 days later for convulsions and a sustained decrease in blood pressure. During the birth process, the use of the drug is extremely contraindicated due to a sharp decrease in the contractile activity of the myometrium.
Magnesia has a pronounced diuretic and laxative effect. It is not recommended for use by women during lactation. But, as an alternative, you can use the powder to add to water and take warm baths.
Magnesia for children
The main purpose of magnesium for children is. Acceptable form is powder by injection IM, IV.
For pathological diseases, enemas can be performed using powder, calculating the child’s weight - 1 g per 1 kg. Doses directly depend on the age of the child. So, for constipation, the powder must be diluted with water - 6 g per 100 ml of warm water for children under 10 years old, for children under 15 years old - 30 g.
An enema is administered into the rectum to relieve spasms and pain.
If used for children with hypertension, the dosage is selected exclusively by the attending physician.
Important! You cannot give medicine to a child together with other drugs (vitamins); you must first consult a doctor. Overdoses and incompatibility of components must be taken into account.
special instructions
It is important to understand that the drug does not cure diseases, but only relieves acute paroxysmal symptoms.
Reference! Magnesia is able to stop a hypertensive crisis, normalize blood pressure for 4-5 hours, but does not completely relieve constant surges in pressure. It is important to take this into account when using it, read the instructions first, take into account side effects and contraindications.
Drug interactions
The instructions say that magnesia is compatible with some drugs, but for example, with high blood pressure it can lead to a change in the effect.
When used together, the effect may be reduced or enhanced in combination with other medications.
Combined use with muscle relaxants will have a peripheral effect, enhancing the effect.
When using magnesium sulfate with Nifedipine, muscle weakness may occur.
Phenothiazine will reduce the effect of magnesium sulfate.
Ciprofloxacin – to increase the antibacterial effect.
Reference! You should not take magnesia together with drugs such as: muscle salts, hydrocortisone, barium, calcium.
Complete incompatibility is observed with Phenothiazine, Nifedipine, Streptomycin. An overdose of magnesia is possible when used with calcium chloride or gluconate.
The drug is incompatible with ethanol (alcohol), bicarbonate, and alkali metals. When used with cardiac glycosides, cardiac conduction may deteriorate or muscle function may be blocked.
Alcohol compatibility
Magnesia is effective for ethanol poisoning due to alcohol abuse. It is given in the form of injections and droppers. It is possible to use powder or tablets to quickly relieve unpleasant signs of intoxication and hangover syndrome.
On a note! Before use, you should first consult your doctor. The anticonvulsant and hypnotic effect may be enhanced, especially when magnesia is used in combination with excessive doses of alcohol.
Conditions for dispensing from pharmacies
Magnesia is sold only with a doctor's prescription.
Conditions and expiration date
Recommended storage temperature is +10+25 degrees in a dry, dark place, in a closed container. Once opened, the powder can be stored for no more than 2 days. The shelf life in the package is 5 years, the solution for injection is 3 years.
Cost of medicine
In Russian pharmacies (Moscow, Russian cities), the average price of magnesium sulfate depending on the number of grams is - 35-58 rubles.
Medicinal analogues
The following have a similar composition and active ingredient:
- Cormagnesin, a vasodilating drug with magnesium properties. Prescribed for deficiency of this mineral, depression, muscle cramps, paresthesia. This is an important intracellular cation that takes an active part in 300 enzymatic reactions, regulating cell homeostasis, normalizing neuromuscular reactions, has a cholinergic effect on nerve endings, leading to a relaxation effect, increasing diuresis, lowering blood pressure, Cost – 615-650 rub.
- , a laxative to relieve constipation and intestinal problems. It has antispasmodic, vasodilating, choleretic, laxative, hypotensive effects. In complex treatment it is used as a symptomatic medication. Indicated for use in cholecystitis, heavy metal intoxication, inflammation of the biliary tract, chronic constipation, convulsions, ischuria, and also for children for gentle bowel movements. Price in powder 10g - 3-8 rub., 10 ampoules (5 ml) solution 18-22 rub.
- Magnesium sulfate Darnitsa with antispasmodic, anticonvulsant, sedative effects. Indicated for use in acute cholecystitis, cholangitis, spasms, convulsions, urinary retention, constipation, lack of magnesium in the body, hypomagnesemia, threat of premature birth. Contains active magnesium sulfate, heptahydrate. Price - 120 rub.
- Dibazol– vasodilator, antispasmodic. Cost in tablets - 20 rub., in solution - 50 rub. The drug is aimed at reducing pressure, dilating blood vessels, accelerating synaptic transmission of impulses in the spinal cord, spasm of smooth muscles and blood vessels, and eliminating renal colic. Analogs: Dibazol Darnitsa, Dibazol UBF, Bendazol. Price - 180 rub. per package.
- Pentoxifylline- an antispasmodic with antiaggregation and anticonvulsant effects to dilate blood vessels and improve blood microcirculation. Indicated for bronchial asthma, otosclerosis, viral neuroinfection, endarteritis obliterans, and impaired blood supply to the periphery. Release form – solution, tablets according to a doctor’s prescription. Analogs: Pentoxifylline, Trental. Cost: tablets – 85-130 rub.(60 pcs), ampoules (2% 5 ml) - 40 rub. for 10 pcs.
- Magnesium sulfide with an anticonvulsant, choleretic, antispasmodic effect to displace calcium, due to its antagonistic properties. Leads to a decrease in quantitative acetylcholine, prevents calcium ions from passing through the presynaptic membrane. Indications for use: dyskinesia of the gallbladder, duodenal intubation, cholecystitis, cholangitis, constipation, poisoning with salts, lead, arsenic and mercury. The acid is applicable for tubing and blind probing. Cost - solution (250 ml) - 30 rub., powder (25 mg) - 35 rub.
Magnesia is widely used for many diseases, but has some contraindications. When using it, it is important to take into account the diagnosis. Dosages are selected individually, taking into account the general well-being of patients.
The injection concentration should not be higher than 25%. When administered intramuscularly, the powder is additionally diluted with water. When administered intravenously, dilution with 5% sodium chloride is acceptable.
Injections may lead to unpleasant sensations (pain, hot skin at the injection site, burning sensation), but as the infusion progresses, the symptoms should quickly subside.
Although you shouldn’t expect a miraculous recovery in a matter of hours when used independently, since the body’s reaction to this substance can be purely individual.
Especially pregnant women and children need to be tested first. Only a doctor can prescribe effective treatment with this drug, in particular the dosage. Self-medication is excluded, otherwise you can cause special harm to the body.