Magnesium is one of the important and irreplaceable elements for the human body. The drug Magnerot normalizes the functioning of the cells and muscles of the heart and participates in the regulation of its contractions.
In stressful situations, large amounts of magnesium are released from the body, resulting in an increased need for additional magnesium intake to combat stress.
In what cases should it be used?
Most often, the medicine is prescribed for chronic heart failure and arrhythmia, which is associated with a lack of salts and magnesium in the human body. The drug repels spastic manifestations and does not allow the development of atherosclerosis.
Indications for use may be greater due to the presence of diseases of the digestive system, when magnesium in food is not absorbed in the stomach, or conditions that require a high content of the active component. These conditions include:
- period of bearing a child;
- chronic alcoholism;
- prolonged physical inactivity;
- prolonged depression.
Literature
1. Barashnev Yu.I. Perinatal neurology. Triad-X, 2001. 2. Gorodetsky V.V., Talibov O.B. Magnesium preparations in medical practice (Small Encyclopedia of Magnesium). M.: Medpraktika-M, 2003. 3. Gromova O.A. Magnesium and pyridoxine: basic knowledge. M.: 2006. 4. Kosheleva N. G. The role of hypomagnesemia in obstetric pathology and methods of its correction. Vestn. Ross. assoc. obstetricians-gynecologists. 1999; 1:42–46. 5. Kosheleva N.G., Arzhanova O.N., Pluzhnikova T.A. Miscarriage: Etiopathogenesis, diagnosis, clinic and treatment, St. Petersburg: 2003; 70. 6. Kudrin A.V., Gromova O.A. Microelements in neurology. M.: GEOTAR-Media, 2006. 7. Pathophysiology. Course of lectures: textbook / Ed. P.F. Litvitsky. M.: Medicine, 1995. 8. Mezhevitinova E.A., Akopyan A.N. Magnesium deficiency conditions in gynecological practice: clinical assessment and methods of correction. Issues of gynecology, obstetrics and perinatology. 2007; 6 (4): 91–98. 9. Ninkova E., Vladova D., Marinova M. The drug Magnerot in the treatment of threatened abortions and premature births. Bulgarian doctor. 1997; 82: 8: 4. 10. Polushkina E.S., Shmakov R.G. Use of magnesium in obstetrics. Attending doctor. 2010; 11:33–39. 11. Savelyeva G.M., Sichinava L.G. et al. Improving perinatal outcomes is one of the main problems of modern obstetrics. Russian Bulletin of Obstetrician-Gynecologist. 2008: 6: 56–60. 12. Sidelnikova V.M. Use of Magne B6 in a miscarriage clinic. Obstetrics and gynecology. 2002; 6:47–48. 13. Sidelnikova V.M. Habitual pregnancy loss. Triad-X, 2004. 14. Strizhakov A.N., Ignatko I.V., Martirosyan N.T. Principles of complex treatment of threatened miscarriage in women with recurrent miscarriage. Issues of gynecology, obstetrics and perinatology. 2008; 7: 2. 15. Chekman I.S., Gorchakova N.A., Nikolai S.L. Magnesium in medicine. Chisinau, 1992. 16. Altura BM Basic biochemistry and physiology of magnesium: a brief review. Magnesium & Trace Elements. 1991; 10: 167–171. 17. Ebel H., Gunther T. Magnesium metabolism: a review. J. Clin. Chem. & Clin. Biochem. 1998; 18: 257–270. 18. James MFM Magnesium in obstetrics. Best Pract & Res Clin Obst & Gyn. 2010; 24:3:327–337. 19. Planells E, Montellano MA et al. Vitamin B6 and B12 and folate status in an adult Mediterranean population. Eur J Clin Nutr. 2003; 57:775–854. 20. Institute of medicine (US). Standing Committee on the Scientific Evaluation of dietary reference intakes. Food and nutritional board. Diatary reference intakes for folate, other B viatamins and choline. Washington DC: National Academy press. 1999; 150–195.
How to take Magnerot
The drug must be taken orally. To enhance the effectiveness of taking it, you need to take the tablet 1 hour before meals. The tablet should be taken with a sufficient amount of purified water. The duration of therapy depends on the patient’s condition and is determined only by a specialist. But there is also a general treatment plan. Initially, you need to take 2 tablets 3 times a day for 7 days. Then reduce to 1 tablet at a time. You can take a maximum of 6 tablets per day. In the absence of contraindications, the drug can be used for a long time.
For night cramps, Magnerot is also prescribed. At night you need to take up to 3 tablets at a time.
Magnerot in Complex Therapy of Threatened Abortion during the First Trimester of Pregnancy
VA Lebedev, IV Ignatko, VM Pashkov
Department of Obstetrics, Gynecology and Perinatology, IMSechenov First Moscow State Medicine University
The article discusses the role of magnesium ions and perspectives of magnesium preparations (Magnerot) usage in the complex treatment of various types of early pregnancy pathologies, including threatened abortion during the first trimester. Keywords: pregnancy, first trimester, threatened abortion, magnesium.
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In recent years, the scope of scientific interests in perinatal fetal protection has shifted to the early stages of pregnancy - to the first trimester, since it is during this period that the fetoplacental system is formed, the formation of fetal organs and tissues, and extraembryonic structures, which in most observations determines the further course of pregnancy. In later stages of pregnancy, when complications arise and a woman has extragenital pathology, the issues of diagnosing the state of the fetoplacental system and fetus and obstetric tactics become more complicated. Thanks to the introduction of highly effective research methods, it became possible to comprehensively diagnose fetal disorders from the earliest stages, determine their severity and pathogenetic features of the development of clinical manifestations of placental insufficiency [5, 14].
One of the most common causes of chronic fetal suffering is threatening and incipient termination of pregnancy, most often observed in women with recurrent pregnancy loss. The medical and social significance of the problem of miscarriage, its impact on perinatal morbidity and mortality rates and the reproductive health of women place scientific research in this area among the most important tasks of modern fundamental and clinical medicine.
Despite the progress achieved in recent years in the prevention and treatment of threatened miscarriage and habitual loss, the frequency of spontaneous miscarriages remains stable and quite high. Thus, according to various authors, it ranges from 2 to 55%, reaching 50% in the first trimester [11, 13]. In addition to the frequency of early reproductive losses, the relevance of the problem of miscarriage is due to the high level of perinatal morbidity and mortality. According to Yu.I. Barashnev [1], the high level of perinatal and childhood morbidity with the threat of miscarriage is determined by the high frequency of placental insufficiency, which develops in 47.1–84.8%. The desire to reduce perinatal morbidity and mortality in fetal loss syndrome is the reason for searching for the basic principles of early prevention, timely diagnosis and adequate treatment of pregnancy complications.
The threat of abortion in the first trimester is especially important, since it is at this time that the first wave of cytotrophoblast invasion and gestational reorganization of the spiral arteries, erosion of their end sections occurs, followed by the penetration of the cytotrophoblast into the lumen of the former spiral arteries and its active proliferation in the zone of dead endothelium. Thus, especially in the presence of increased myometrial tone, additional obstacles are created for the full development of the ovum with a decrease in the depth of invasion and the subsequent formation of disturbances in fetoplacental blood flow [14].
Microelements, in particular magnesium, play a very important role in the pathogenesis of threatened miscarriage. Therefore, the clinical picture of a threatened miscarriage will also include pain caused by increased myometrial tone. and psychophysiological discomfort that arise due to magnesium deficiency.
Magnesium is one of the vital microelements and is found mainly in bone, muscle and nerve tissues. Less than 1% of the total magnesium in the body is found in plasma and red blood cells. About 60% of magnesium contained in plasma is in an ionized state, and the rest is associated with albumin or complexed with ions, mainly citrate and phosphate [18].
Magnesium takes an active part in the regulation of many physiological processes of the human body. In terms of content in the body, magnesium ranks fourth after sodium, potassium and calcium, and in terms of content in cells it ranks second (after potassium). Up to 80–90% of intracellular magnesium is in complex with ATP, and therefore the level of ATP is one of the main factors limiting its accumulation in the cell [2, 6, 8].
In terms of its specific gravity in the chemical composition of the body, magnesium ranks fourth after sodium, potassium and calcium, and its total content reaches 25 g, with almost all of magnesium being an intracellular cation. Magnesium serves as an obligatory cofactor for more than 300 enzymes that normally regulate various body functions [7, 16, 17]. Magnesium plays a leading role in energy, plastic and electrolyte metabolism. It acts as a regulator of cell growth and is necessary at all stages of the synthesis of protein molecules. In particular, the normal functioning of ribosomes and the binding of messenger RNA, a key mechanism of protein biosynthesis, depend on the presence of a sufficient amount of magnesium. The microelement directly regulates the state of the cell membrane and the transmembrane transport of calcium and sodium ions, and also independently participates in many metabolic reactions for the formation, accumulation, transfer and utilization of energy, free radicals and their oxidation products. Magnesium is called the metal of life. All energy processes in the body occur with its participation.
Magnesium is involved in the regulation of metabolic processes in the body: in energy (complexation with ATP and activation of ATPases, oxidative phosphorylation, glycolysis), plastic (synthesis of protein, lipids, nucleic acids) and electrolyte metabolism. In addition, it is a cofactor for many enzymes, acts as a calcium antagonist, and takes part in the relaxation of muscle fibers other than the heart muscle. Magnesium also reduces platelet aggregation ability, maintains normal transmembrane potential in electrically excitable tissues, and affects the endothelium, which plays a key role in vascular homeostasis, in particular, through the production of nitric oxide and participation in the control of platelet aggregation. It has been proven that magnesium ion deficiency increases the activity of thromboxane A2, which is accompanied by damage to the vascular wall. The protective effect of magnesium on neurons is manifested by inhibition of calcium channels and antagonism with the N-methyl-D-aspartic acid receptor [18].
The daily requirement for magnesium is 350 mg for men and 280 mg for women and increases during pregnancy and lactation by at least one and a half times (360–400 mg/day). During pregnancy, the daily requirement for magnesium increases due to an increase in uterine weight from 100 to 1000 g and total blood weight (due to an increase in the number of red blood cells) by 18–30%. In this regard, doctors often have questions about normal electrolyte levels for pregnancy. Often the concentration of magnesium ions is within the normal range (0.8–1.1 mmol/l), but the body is already suffering from its deficiency.
During breastfeeding, for the normal development of the growing body of a newborn, the concentration of magnesium in breast milk should be 30–40 mg/l [15]. The richest magnesium crops are grains, legumes, greens, nuts, and chocolate. The absorption of magnesium from food products is 30–35%.
Regulation of magnesium levels depends on renal excretion. Excess plasma calcium and magnesium activates the calcium receptor in the kidneys and thereby increases diuresis to remove excess of both ions. Thus, magnesium leads to an increase in its own clearance with normal renal function.
The generally accepted plasma magnesium level is 0.75–1.0 mmol/L. However, magnesium is an intracellular ion, so its deficiency in the body can be present even with normal and elevated plasma magnesium levels [18].
It was found that magnesium levels decrease during pregnancy, reaching a minimum value at the end of the first trimester, partly due to dilution and release into the extracellular space and partly due to absolute magnesium deficiency. Magnesium deficiency has numerous consequences, including chronic fatigue, delirium, weakness and seizures, impaired glucose metabolism, a variety of arrhythmias, vascular disorders and disturbances of electrolyte metabolism, especially potassium. The immediate manifestations of magnesium deficiency most often include a rapidly developing lack of magnesium in the body, which leads to a state of increased nervous excitability of the cell. Clinically, it manifests itself as muscle twitching and cramps, most often in the calf muscles, which is a common problem during pregnancy. Arrhythmia in pregnant women is also often associated with magnesium deficiency. Magnesium deficiency during pregnancy increases the risk of insulin resistance and diabetes. Magnesium deficiency during pregnancy can lead to the development of placental insufficiency, preeclampsia due to spasm of the uterine arteries, and fetal growth restriction syndrome [18]. Magnesium also has a significant effect on the condition of connective tissue. During pregnancy, prolonged magnesium deficiency can provoke the development of stretch marks in the chest and abdomen in a woman during a period of rapid breast growth and an enlarged uterus. Childbirth in women with magnesium deficiency is more often complicated by perineal ruptures [4].
Magnesium deficiency causes hypercalcemia and hyperphosphatemia. Magnesium is very important for the normal activity of cell membranes. Magnesium activates the secretion of parathyroid hormone, thereby normalizing the absorption process from the intestine. Promotes the absorption of phosphorus, potassium, vitamins B, C, E.
In addition, magnesium takes part in phosphorus metabolism, ATP synthesis, regulation of glycolysis, bone tissue building, etc. The role of magnesium in membrane transport processes, where it is a natural calcium antagonist, is particularly important. Magnesium helps inhibit the contractile activity of smooth and striated muscles by relaxing individual cells - myocytes by blocking the calcium-dependent interaction of contractile proteins [3, 15, 20]. When regulating muscle excitability, magnesium is a natural calcium antagonist. In certain doses, it is able to inhibit the contraction of isolated smooth and transverse muscles, regardless of the etiology of constriction. Magnesium serves as a relaxation factor for the myocyte, since the active transport of calcium into the cisterns, which ensures a decrease in its concentration in the cytoplasm and leads to the cessation of the interaction of contractile proteins, is carried out due to the hydrolysis of ATP with the participation of calcium-magnesium-dependent ATPase of the sarcoplasmic reticulum. This is the antispasmodic and anticonvulsant mechanism of action of magnesium [3, 18].
Finally, the most important role of magnesium is related to its central action. Magnesium serves as a natural anti-stress factor, inhibiting the development of excitation processes in the central nervous system and reducing the body’s sensitivity to external influences [3, 19].
It is the absence of the tocolytic effect of magnesium and the increase in excitation processes in the central nervous system due to a deficiency of this microelement that are important components of the pathogenesis of threatened miscarriage.
Magnesium deficiency is manifested by a variety of clinical symptoms and syndromes, which can be grouped according to violations of the basic functions of magnesium [3, 10].
The first group of diseases is caused by the participation of magnesium in enzymes that serve energy reactions - carbohydrate and ATP metabolism. Therefore, a lack of magnesium is accompanied by increased fatigue (mental and physical) under normal loads, and inadequate heat exchange (rapid depletion of energy resources, chilliness).
The second group of diseases is associated with a violation of the electrical excitability of the cell. With a deficiency of Mg2+ ions, their exchange on the cell membrane is disrupted, the electrical excitability of the cells increases and the cell becomes overexcitable:
• hyperexcitability of nerve cells is manifested by emotional lability, tearfulness, irritability, anxiety, depression, poor sleep; • increased excitability of cardiomyocytes can lead to tachycardia and ectopic arrhythmias; • hyperexcitability of vascular smooth muscle cells is accompanied by high blood pressure and headache; • increased excitability of the smooth muscles of the internal organs gives symptoms of unstable stool (constipation, diarrhea, abdominal pain due to impaired intestinal motility), stomach pain, bronchospasms, uterine hypertonicity, cervical spasm during childbirth.
The third group of magnesium dysfunctions is associated with its structure-forming role in mediator metabolism:
• firstly, magnesium forms sites in the structure of a number of receptors (NMDA, AMPA receptors for acetylcholine, norepinephrine and dopamine); • secondly, magnesium is necessary for the normal metabolism of neurotransmitters (catecholamines, tyrosine, dopamine, norepinephrine, serotonin, g-aminobutyric acid).
This group of causes leads to depression, impaired coordination of movements, attention, memory, mood, and is involved in the development of epilepsy, autism, all kinds of phobias and manias. The same patient may have a combination of symptoms from different groups [3, 6].
Long-term magnesium deficiency leads to the development of metabolic disorders. First of all, pathological compartmentalization of elements is formed under the influence of hypomagnesis in various organs, biological fluids and tissues. In hypomagnesium biological environments, calcium salts accumulate over the years (calcification of joints, ligaments, bone aging), calcification of atherosclerotic plaques of the aorta and other vascular localizations (potentiated by pyridoxine deficiency). Stone formation is also initiated in the gall bladder, kidneys and bladder (potentiated by pyridoxine deficiency), and the accumulation of toxic elements (Ni, Pb, Cd, Be, Al). The long-term consequences of magnesium deficiency include the development of arterial hypertension, cardiovascular pathology, an increased risk of myocardial infarction, cerebral stroke, atherosclerosis (potentiated by pyridoxine deficiency), and diabetes. Somatic manifestations of magnesium deficiency can be:
1) cardiovascular (tachycardia, extrasystole, discomfort or pain in the chest); 2) respiratory (feeling of lack of air, shortness of breath); 3) neurological (dizziness, headaches, paresthesia, muscle tension and pain, sleep disturbances); 4) gastrointestinal (nausea, dyspepsia, abdominal pain, flatulence, appetite disturbances); 5) genitourinary (frequent urination, decreased libido); 6) thermoregulatory (unreasonable low-grade fevers and chills).
Currently, the role of magnesium deficiency in the development of a wide variety of pathologies has been proven: cardiovascular (arterial hypertension, arrhythmias, coronary heart disease), endocrine (diabetes mellitus), psychoneurological (anxiety, depression, dizziness, migraine, memory disorders, seizures) , PMS [2, 19].
The daily requirement for magnesium is 350–400 mg for men and 280–300 mg for women. At the same time, pregnancy and lactation increase the need for magnesium by 20-30% - up to 340-355 mg. Magnesium deficiency in the body is very common. Statistics indicate that, for example, in the United States, 25–30% of the population has insufficient dietary intake of magnesium [19]. This is largely due to modern food processing technologies (refining) and the use of mineral fertilizers, which lead to magnesium deficiency in the soil and, accordingly, in plant products. In addition, magnesium deficiency can be caused by dietary disorders, excess calcium in food, alcoholism, use of diuretics, malabsorption in the small intestine, infectious and inflammatory diseases - enteritis, gastroenteritis, endocrine pathology (diabetes mellitus, hypersecretion of aldosterone and thyroid hormones) , chronic stress, sports activities, as well as periods of pregnancy and lactation [2, 19].
Magnesium deficiency is difficult to diagnose. A blood test readily available in the clinic does not provide complete information about the magnesium content in the body, since a decrease in magnesium concentration can be compensated by its release from bone depots. However, if concentrations below 0.8 mmol/L are detected in the blood plasma, a diagnosis of magnesium deficiency can practically be made.
It should be noted that the normal level of magnesium in the body is recognized as a fundamental constant that controls human health. Since 1994, WHO has classified the pathological condition “magnesium deficiency” as a disease with its own code; according to the ICD, “magnesium deficiency” is coded as E61.3 and is more often found as a concomitant diagnosis [3].
Currently, there are several methods for assessing magnesium levels in the body. In most cases, deficiency of this microelement does not have pathognomonic clinical signs and is characterized by polysymptomatic manifestations, which are due to its participation in the regulation of many physiological processes of the human body. The normal level of magnesium in blood serum in adults is 0.75–1.26 mmol/l; in pregnant women – 0.8–1.05 mmol/l (deficiency in pregnant women is often underestimated due to incorrect interpretation on the “adult” scale); in children – 0.74–1.15 mmol/l. However, serum magnesium levels can remain within normal limits even when the total amount of magnesium in the body decreases by 80% due to the release of the trace element from bone depots. Therefore, normomagnesemia does not exclude possible magnesium deficiency. Therefore, the detection of hypomagnesemia (serum magnesium less than 0.8 mmol/l) is a sign of severe magnesium deficiency in the body. The method for determining the magnesium content in hair makes it possible to characterize the state of magnesium homeostasis as a whole and reflects stable indicators formed over long periods of time (weeks, months, years). This method, according to fundamental research, allows one to reliably identify and assess the degree of magnesium deficiency [3].
Considering the above, the use of magnesium preparations in the complex treatment of threatened miscarriage should be considered pathogenetically justified. Magnesium preparations can be inorganic and organic. The first generation of magnesium preparations includes inorganic compositions: magnesium oxide, sulfate, chloride, etc.; the second - organic compounds: magnesium orotate, lactate, pidolate and others [3, 10, 12]. The bioavailability of organic magnesium salts is almost an order of magnitude higher than that of inorganic ones. Thus, the bioavailability of magnesium orotate is several times (5–6 times) higher than that of magnesium sulfate. Magnesium pidolate, citrate, gluconate, and aspartate have a higher excretory capacity (in urine) than inorganic salts. Inorganic magnesium salts are less well tolerated and more often cause dyspeptic complications (diarrhea, vomiting, abdominal cramps). Organic magnesium salts are not only much better absorbed, but also easier to tolerate by patients and less likely to cause side effects from the digestive tract.
Treatment will be more effective if both magnesium and a magnesium fixative, such as orotic acid, are administered simultaneously. Orotic acid is a good magnesium fixative because it improves the bioavailability of magnesium, promotes the penetration of magnesium into cells and its retention inside [3, 9, 10].
Considering the great importance of magnesium in the pathogenesis of threatened miscarriage, we conducted a clinical evaluation of the therapeutic effect of the drug Magnerot. 1 tablet of the drug Magnerot (Woerwag Pharma, Germany) contains: 500 mg of magnesium orotate (32.8 mg in terms of pure magnesium).
In order to evaluate the effectiveness of the use of the drug Magnerot in the complex treatment of threatened miscarriage, we conducted a comprehensive clinical and laboratory examination of 64 pregnant women with clinical manifestations of threatened miscarriage in the period from 5 to 13 weeks of gestation, aged from 19 to 38 years, average age 22.3± 2.7 years. The examination included a thorough examination of the medical history, assessment of clinical data of threatened miscarriage (the severity of pain), a detailed ultrasound examination (with embryometry), and determination of the concentration of magnesium in the blood serum before and during therapy. Normal magnesium concentrations were considered to be 0.8–1.0 mmol/l. Magnesium therapy with Magnerot was prescribed as follows: in the 1st week - 2 tablets 3 times a day daily, from the 2nd to 4th weeks - 1 tablet 3 times a day daily.
The research results showed that there were 40 (62.5%) primiparous women and 24 (37.5%) multiparous women. The majority of those examined had a burdened obstetric history: induced abortions in 23 (35.9%), spontaneous miscarriages in 11 (17.2%). The most common extragenital pathologies were: vegetative-vascular dystonia – in 10, chronic cholecystitis – in 3, chronic pyelonephritis – in 6.
As a result of the therapy, the majority of women (52–81.25%) experienced a significant improvement: the phenomena of threatening miscarriage were stopped (the pain syndrome stopped, the tone of the uterus was normalized according to ultrasound). All patients showed normalization of magnesium concentrations in the blood (table). 12 patients out of a total of 64 examined required intensification of maintenance therapy with the addition of natural micronized progesterone (utrozhestan), as a result of which a clinical effect was achieved.
Thus, studies have shown that threatened abortion is accompanied by a decrease in the concentration of magnesium in the blood. The use of Magnerot in most patients provides a pronounced clinical and biochemical effect. The data obtained indicate that the drug Magnerot can be recommended as an effective therapeutic agent for threatened abortion.
Side effects
The medicine in tablet form is well absorbed by the body, but if you neglect the established treatment regimen and regularly exceed the dose, then unwanted reactions may occur. They may manifest as stomach upsets. In this case, you need to reduce the dose and expect relief.
In practice, there are cases when urticaria, skin itching and rash appeared after taking it. If such manifestations occur, you need to contact a specialist who will adjust the treatment regimen.
Overdose
If the dose is exceeded, magnesium intoxication may occur. With normal kidney function, such a problem is almost impossible. Excess of the substance can lead to the following conditions:
- gag reflex, diarrhea, pain in the abdomen;
- paralysis of the respiratory muscles;
- violation of the patency of the stomach and bile ducts.
To cope with such conditions, you need to consume as much potassium as possible. It is also necessary to take in as much water as possible.
special instructions
The drug can be stored for 5 years from the date of manufacture. Should be kept in a dry place at room temperature away from children.
The medicine should not be used in parallel with sodium fluoride and iron salts. The combination of Magnerot with tranquilizers and sedatives enhances their effect on the body.
The medication can be purchased at a pharmacy. No doctor's prescription required. On average, the medicine costs 380-500 rubles.
The drug and its analogues do not in any way affect the ability to drive a vehicle or operate other mechanisms that require increased attention.
Is it possible to take Magnerot during pregnancy?
From an objective point of view, the drug can be prescribed to women during pregnancy. But even a slight excess of the dosage can cause serious consequences, including miscarriage. Therefore, Magnerot can be taken only as prescribed by a doctor, if the expected benefit significantly outweighs the possible danger to the baby.
Reviews from pregnant women indicate that if the treatment regimen is followed, the drug is well tolerated by the body.
Some experts prescribe the drug for severe swelling, increased blood pressure, and tremors in the arms and legs. For edema, magnesium can be given to pregnant women at 4-8 months. The medicine also improves uterine blood flow, which has a positive effect on the condition of the pregnant woman.
V.A. Lebedev, I.V. Ignatko, V.M. Pashkov
Department of Obstetrics, Gynecology and Perinatology, First Moscow State Medical University named after.
I.M. Sechenova The article discusses the role of magnesium ions and the prospects for using magnesium preparations (Magnerot) in the complex treatment of various types of pathology in early pregnancy, including threatened miscarriage in the first trimester. Key words: pregnancy, first trimester, threatened miscarriage, magnesium.
Information about the author: Vladimir Aleksandrovich Lebedev, Doctor of Medical Sciences, Professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine, First Moscow State Medical University named after. I.M.Sechenova
Which is better: Magnesium B6 or Magnerot
A direct analogue of Magnerot is Magnesium B6. Both drugs have a similar effect on the body, but their structure is different.
The Magnerot medication contains exclusively magnesium compounds, while Magna B6 contains pyridoxine. The action of the drugs is aimed at replenishing the lack of magnesium in the body. Magne B6 cannot be classified as a cheap analogue.
If you have heart disease, high blood pressure, migraines, or excessive sweating, it is better to take Magnerot, since this medicine is aimed specifically at treating problems with the heart and blood vessels.
Cheaper but effective analogues include: Magnelis B6, Vitrum mag. The latter drug replenishes not only the lack of magnesium in the body, but also calcium.
Pharmacological properties of the drug Magnerot
Magnesium preparation. Magnesium is a macronutrient, an important intracellular cation. Takes part in reactions involving over 300 enzymes, in the regulation of cellular permeability and neuromuscular transmission. Magnesium is necessary for many energy processes, takes part in the metabolism of proteins, fats, carbohydrates and nucleic acids, and is a natural physiological calcium antagonist. Controls the normal functioning of myocardial cells; takes part in the regulation of its contractile function; can reduce peripheral vascular resistance, improve coronary circulation. Along with eliminating the symptoms of magnesium deficiency, magnesium demonstrates a curare-like effect on cholinergic nerve endings by reducing the release of acetylcholine and can inhibit platelet aggregation. Magnesium orotate promotes cell growth and takes part in the metabolic process. In addition, the orotic acid derivative is necessary for the fixation of magnesium on ATP in the cell and the manifestation of its action, and also accelerates regeneration processes, improves the synthesis of pyrimidine bases, and the synthesis of nucleic acids. Magnesium orotate exhibits a very low level of dissociation. Only after penetration into the cell is this substance broken down into its components. Approximately 55% of magnesium is in ionized form, 32% is bound to proteins, mainly albumin, α1- and β2-globulins, and 13% is in the form of salts, mainly in the form of phosphates and citrates. Approximately 60% of total magnesium accumulates in bone tissue, 40% in the intracellular space and about 1% is located in the extracellular fluid. This is one of the reasons why, based on determining the level of magnesium in the blood, it is impossible to draw a conclusion about the overall balance of magnesium in the body. 90% of magnesium that accumulates inside cells is bound to ATP in the cytosol, RNA in ribosomes and DNA in cell nuclei. A deficiency of ATP, for example, leads to loss of magnesium. Orotic acid is capable of increasing ATP content and therefore acts as a magnesium fixer in cells . As a result of metabolism, it is converted into uridine monophosphate, which is an intermediate product of pyrimidine metabolism. Magnesium is excreted in both feces and urine. It is also excreted through sweat and breast milk.
