Description of the drug MAGNESIUM SULPHATE (MAGNESII SULFAS)

Magnesium sulfate as a laxative

For 1 glass of boiled water you need to take 15-30 g of powder, stir everything and drink. To enhance the laxative effect, you need to consume as much warm liquid as possible. In this case, you will be able to notice the result within 30-40 minutes.

In no case should you take magnesium sulfate for several days in a row, otherwise you can damage the gastric mucosa, which can lead to serious consequences. For acute constipation, the product is used once. To empty the bowel, it is sometimes used together with anthelmintic drugs. For chronic constipation, enemas are done using a solution. To do this, you need to take 25 g of powder and dilute it in half a glass of water.

pharmachologic effect

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 nervous system 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 (decreased absorption, binding and distribution of calcium in smooth muscle cells), increases blood flow in the uterus as a result of dilation 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.

Contraindications

You should avoid taking magnesium sulfate if:

• bleeding in the rectum;
• dehydration of the body;
• intestinal obstruction;
• inflammation of appendicitis.

Should be taken under medical supervision if:

• inflammation of the gastrointestinal tract;
• respiratory problems;
• renal failure.

Directions for use and doses

Intravenously. Doses are adjusted taking into account the therapeutic effect and the concentration of magnesium ions in the blood serum. Preeclampsia and eclampsia. The dose is set individually depending on the clinical situation. Saturation dose - 2-4 g every 5-20 minutes (infusion). Maintenance dose: 1-2 g and hour. Uterine tetany. Saturation dose - 4 g every 20 minutes (infusion). Maintenance dose - first - 1-2 g per hour, later - 1 g per hour (can be administered drip-wise for 24-72 hours). Hypomagnesemia. In newborns. The daily dose is 0.2-0.8 mg/kg IV slowly. In adults. Easy. Magnesium sulfate solution is used parenterally if the oral route of administration of magnesium preparations is impossible or impractical (due to nausea, vomiting, impaired resorption in the stomach, etc.). Heavy. The initial dose is 5 g. The dose is poured into 1 liter of infusion solution and slowly administered intravenously. Dosage depends on the concentration of the drug in the blood serum. 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. The maximum daily dose of magnesium sulfate for adults is 40 g. For hypertensive crises, 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. Doses of magnesium sulfate are indicated in grams. They correspond to the amount of 25% solution: Magnesium sulfate solution in ampoules is diluted with injection solutions: 0.9% sodium chloride or 5% dextrose (glucose).

How to take Magnesium Sulfate for weight loss

Before dieting, it is necessary to cleanse the intestines. Magnesium sulfate in this case is intended for one-time use. This method should not be used frequently, since the active substance irritates the gastric mucosa and can ultimately cause dysbacteriosis.

Those who want to lose weight need to add 200 g of powder to the bath. This bath should be taken for 20 minutes before bedtime. The course contains no more than 15 such procedures. It should be done no more than twice a week. The effect is achieved as follows: unnecessary fluid leaves the body, swelling disappears, and metabolic processes improve.

special instructions

It should be borne in mind that IM injections are extremely painful and lead to the formation of infiltrates. Magnesium sulfate should be used carefully to avoid toxic concentrations of the drug. 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; 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), and blood pressure. When administering magnesium sulfate, it is necessary to have a calcium solution prepared for intravenous administration, for example, a 10% solution of calcium gluconate. If simultaneous intravenous administration of magnesium and calcium is necessary, they are injected into different veins. When using magnesium sulfate, the results of radiological studies for which technetium is used may be distorted.

Interaction with other drugs

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). 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.

Description of magnesia

Magnesia: release form - ampoules with solution

Magnesia is a magnesium salt of sulfuric acid - magnesium sulfate. Latin name Magnesii sulfas. The powder is colorless, prismatic crystals that easily erode in air. This salt is highly soluble in water and completely insoluble in alcohol.

It is also called bitter for its bitter-salty taste. It is contained in sea salt and determines the bitter taste of sea water. Magnesia is available in the following dosage forms:

• Powder. In this form it is packaged in paper bags or plastic jars of 5, 10, 25 g.
• 25% solution, in ampoules. Available for injection.

The last dosage form, in ampoules, will be discussed in this article. Magnesia injections are performed intravenously and intramuscularly. When administered intravenously, the drug begins to act within a few minutes, and the effect lasts for an hour; when administered intramuscularly, the magnesium solution begins its effect after an hour and the effect lasts for 3-4 hours.

It is not recommended to inject magnesium subcutaneously, since the effectiveness of such injections is low, but the pain can be simply unbearable. The patient experiences a severe painful burning sensation even if the drug accidentally gets under the skin.

Magnesium sulfate solution for intravenous administration 250 mg/ml ampoules 10 ml 10 pcs. in Moscow

Latin name

Magnesium sulfate

International nonproprietary name

magnesium sulfate

Release form

Solution for intravenous administration.

Package

10 ampoules. 10 pieces

Description

Transparent colorless liquid.

pharmachologic effect

When taken orally, it has a choleretic (reflex effect on the receptors of the duodenal mucosa) and a laxative effect (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, and 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 - a curare-like (inhibitory effect) on neuromuscular transmission), tocolytic, hypnotic and narcotic effects, 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, 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.

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).

Directions for use and doses

Individual, depending on the indications and dosage form used. Intended for oral administration, intramuscular and intravenous (slow) administration, administration through a duodenal tube.

Compound

1 ml of the drug contains: magnesium sulfa - 250 mg; Excipient: water for injection - up to 1 ml.

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).

Use during pregnancy and breastfeeding

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.

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 calcium gluconate - are used as an antidote for an overdose of magnesium sulfate.

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 peripherally acting muscle relaxants, the effects of peripherally acting 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 - calcium chloride or calcium gluconate - are used as an antidote for an overdose of magnesium sulfate. Pharmaceutically incompatible (precipitate is formed) with Ca2+ preparations, ethanol (in high concentrations), carbonates, hydrocarbonates and phosphates of alkali metals, salts of arsenic acid, barium, strontium, clindamycin phosphate, hydrocortisone sodium succinate, polymyxin B sulfate, procaine hydrochloride, salicylates and tartrates .

Storage conditions

At a temperature not exceeding 30C.

Magnesia and calcium - two things do not go together

An overdose of magnesium in humans paralyzes breathing. The pressure drops sharply, and if urgent measures are not taken, the patient may die. It is calcium ions that can revive a patient in this state before the heart stops. Therefore, calcium gluconate or calcium chloride is injected into the patient’s blood as an antidote. Calcium ions displace magnesium ions and thereby change the chemical composition and physical properties of the sulfate salt.

Magnesia, in turn, is a calcium antagonist. Its mechanism of action is that magnesium sulfate prevents the penetration of calcium ions from the cell into the heart muscle tissue through slow L-type calcium channels. Due to the decrease in positive calcium ions in cardiomyocytes and smooth muscle cells of blood vessels, a vasodilator effect occurs.

But, despite this interaction, situations arise when the patient is simultaneously injected with magnesia and preparations containing calcium. It is recommended to give such injections into different veins.

Side effect

Slowing breathing rate; dyspnea; acute circulatory failure; weakening of reflexes; hyperemia; arterial hypotension; hypothermia; weakening of muscle tone; uterine atony; hyperhidrosis; anxiety; pronounced sedation; polyuria; reduction in heart rate; changes in the electrocardiogram. The drug reduces the excitability of the respiratory center; large doses of the drug when administered parenterally can easily cause paralysis of the respiratory center. Early signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden flushing of the face, headache, decreased blood pressure, nausea, shortness of breath, slurred speech, vomiting, general weakness. 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).

Application of magnesia

The introduction of magnesium must be very careful

Taking into account all of the above, the instructions for use provide for magnesium injections in the following cases:

1. Threat of premature birth. Magnesia stops contractions, that is, spastic contractions of the uterine muscles that expel the fetus. Pregnant women are sometimes prescribed magnesia in the form of a dropper. Indications for the drug are also convulsions during complicated pregnancy, so-called gestosis. In this condition, increased blood pressure and swelling are observed. Preeclampsia is dangerous; it is one of the leading causes of female mortality during childbirth. The most acute form of gestosis is eclampsia, a condition in which the pressure can reach a critically high point, threatening the life of the mother and child.
2. Deficiency of magnesium in the body, and especially of positively charged Mg ions. Acute magnesium deficiency leads to tetany;
3. Polymorphic ventricular tachycardia, known as “feasting”;
4. High blood pressure (hypertension), including those aggravated by a hypertensive crisis with obvious signs of cerebral edema;
5. Brain concussion;
6. Encephalopathy is a decrease in brain function due to degenerative changes in brain tissue.
7. Intoxication with salts of heavy metals (mercury, lead);
8. First aid for poisoning with barium chloride, arsenic;
9. For severe attacks of bronchial asthma, intravenously and inhaled, in combination with OI2 agonists.

Magnesia has some narcotic effects and can be used to enhance the effects of narcotics and analgesics.

In addition to internal administration, magnesium solution is used in physiotherapy for electrophoresis, which has a calming and vasodilating effect; as medicinal baths, compresses, lotions for wounds. External use of magnesium promotes blood flow in the tissues of the skin, relieves pain and has a resorption effect.