Magnesium sulfate (medical use)

Magnesium sulfate as a medication is used to treat and prevent low blood magnesium and seizures in women with eclampsia.[2] It is also used in the treatment of torsades de pointes, severe asthma exacerbations, constipation, and barium poisoning.[2][3] It is given by injection into a vein or muscle as well as by mouth.[2][3] As epsom salts, it is also used for mineral baths.[4]

Magnesium sulfate
Magnesium sulfate heptahydrate
Clinical data
Trade namesEpsom salt, others
AHFS/Drugs.comMonograph
Pregnancy
category
    Routes of
    administration
    IV, IM, by mouth, topical
    ATC code
    Identifiers
    CAS Number
    PubChem CID
    DrugBank
    ChemSpider
    UNII
    ChEBI
    ChEMBL
    Chemical and physical data
    FormulaMgSO4 - 7H2O
    Molar mass120.366
    3D model (JSmol)

    Common side effects include low blood pressure, skin flushing, and low blood calcium.[2] Other side effects may include vomiting, muscle weakness, and decreased breathing.[5] While there is evidence that use during pregnancy may harm the baby, the benefits in certain conditions are greater than the risks.[6] Its use during breastfeeding is deemed to be safe.[6] Magnesium sulfate for medical use is the magnesium sulfate heptahydrate salt.[3] The way it works is not fully understood, but is believed to involve depressing the action of neurons.[2]

    Magnesium sulfate came into medical use at least as early as 1618.[7] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[8] The wholesale cost in the developing world is about US$0.35–8.73 per 10 ml of 50% solution.[9] In the United Kingdom 4 ml of 20% solution costs the NHS about 10.23 pounds.[3] In the United States a course of medication typically costs less than $25.[1]

    Medical uses

    Magnesium Sulfate IV solution

    Eclampsia

    Magnesium sulfate is the primary treatment and preventative measure in women with eclampsia.[3] It lowers systolic blood pressure while maintaining diastolic blood pressure, thus leaving blood flow to the fetus uncompromised.

    Early delivery

    Magnesium sulphate was once used as a tocolytic,[10][11] but meta-analyses have failed to support it as an anti-contraction medication.[12][13] Usage for prolonged periods (more than five to seven days) may result in health problems for the baby.[14]

    In those at risk of an early delivery, magnesium sulfate appears to decrease the risk of cerebral palsy.[15][16] It is unclear if it helps those who are born at term.[17] Guidelines for the use of magnesium sulfate in mothers at risk of preterm labour are not strongly adhered to.[18]

    Bath salts

    Magnesium sulfate is used in bath salts, particularly in flotation therapy, where high concentrations raise the bath water's specific gravity, effectively making the body more buoyant. Traditionally, it is also used to prepare foot baths, intended to soothe sore feet. The reason for the inclusion of the salt is partially cosmetic: the increase in ionic strength prevents some of the temporary skin wrinkling (partial maceration) which is caused by prolonged immersion of extremities in pure water. Magnesium and sulfate ions are naturally present in some mineral waters.[19] The claimed health benefits of Epsom Salt baths have not been proven.[20]

    Paste

    A magnesium sulphate paste is also available which is claimed to be useful for small boils or localised infections.[21] The standard British Pharmacopoeia composition is dried Magnesium Sulfate 47.76% w/w, Phenol 0.49% w/w. and glycerol (E422).[21]

    Research

    Magnesium sulfate has been used as an experimental treatment of Irukandji syndrome caused by envenomation by certain species of Irukandji jellyfish, but the efficacy of this treatment remains unproven.[22]

    See also

    References

    1. Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 220. ISBN 9781284057560.
    2. "Magnesium Sulfate". The American Society of Health-System Pharmacists. Archived from the original on 21 May 2016. Retrieved 8 January 2017.
    3. British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 696. ISBN 9780857111562.
    4. Kogel, Jessica Elzea (2006). Industrial Minerals & Rocks: Commodities, Markets, and Uses. SME. p. 625. ISBN 9780873352338. Archived from the original on 2017-09-18.
    5. WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 75. ISBN 9789241547659. Archived (PDF) from the original on 13 December 2016. Retrieved 8 January 2017.
    6. "Magnesium sulfate Use During Pregnancy | Drugs.com". www.drugs.com. Archived from the original on 2017-07-02.
    7. Willett, Edward (2006). Magnesium. The Rosen Publishing Group. p. 5. ISBN 9781404210073. Archived from the original on 2017-09-18.
    8. "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
    9. "Magnesium Sulfate". International Drug Price Indicator Guide. Retrieved 8 December 2016.
    10. "Magnesium sulfate for preterm labor". Webmd.com. 2007-01-19. Archived from the original on 2009-06-24. Retrieved 2009-07-06.
    11. Lewis DF (September 2005). "Magnesium sulfate: the first-line tocolytic". Obstetrics and Gynecology Clinics of North America. 32 (3): 485–500. doi:10.1016/j.ogc.2005.03.002. PMID 16125045.
    12. Simhan HN, Caritis SN (2007). "Prevention of Preterm Delivery". New England Journal of Medicine. 357 (5): 477–487. doi:10.1056/NEJMra050435. PMID 17671256.
    13. Nanda, K; Grimes, DA (2006). "Magnesium sulfate tocolysis: Time to quit". Obstetrics and Gynecology. 108 (4): 986–989. doi:10.1097/01.AOG.0000236445.18265.93. PMID 17012463.
    14. "Magnesium Sulfate: Drug Safety Communication – Recommendation Against Prolonged Use in Pre-term Labor". FDA. Archived from the original on 3 June 2013. Retrieved 2 June 2013.
    15. Doyle, LW; Crowther, CA; Middleton, P; Marret, S; Rouse, D (January 21, 2009). "Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus". The Cochrane Database of Systematic Reviews (1): CD004661. doi:10.1002/14651858.CD004661.pub3. PMID 19160238.
    16. Wolf, HT; Hegaard, HK; Greisen, G; Huusom, L; Hedegaard, M (February 2012). "Treatment with magnesium sulphate in pre-term birth: a systematic review and meta-analysis of observational studies". Journal of Obstetrics and Gynaecology. 32 (2): 135–140. doi:10.3109/01443615.2011.638999. PMID 22296422.
    17. Nguyen, TM; Crowther, CA; Wilkinson, D; Bain, E (February 28, 2013). "Magnesium sulphate for women at term for neuroprotection of the fetus". The Cochrane Database of Systematic Reviews. 2: CD009395. doi:10.1002/14651858.cd009395.pub2. PMID 23450601.
    18. Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob (10 January 2018). "Economic evaluation and cost of interventions for cerebral palsy: a systematic review". Developmental Medicine & Child Neurology. doi:10.1111/dmcn.13653. PMID 29319155.
    19. "Bath - Hot Springs". Archived from the original on 27 October 2007. Retrieved 16 October 2016.CS1 maint: BOT: original-url status unknown (link)
    20. Ingraham, Paul. "Does Epsom Salt Work? The science of Epsom salt bathing for recovery from muscle pain, soreness, or injury". Pain Science. Archived from the original on 10 September 2016. Retrieved 29 August 2016.
    21. "Boots Magnesium Sulfate Paste B.P. - Patient Information Leaflet (PIL) - (eMC)". www.medicines.org.uk. Retrieved 14 April 2018.
    22. Corkeron M (2003). "Magnesium infusion to treat Irukandji syndrome". Medical Journal of Australia. 178 (8): 411. PMID 12697017.
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