Magnesium sulfate 5 ml instructions for use. Magnesium sulfate is a laxative for quick bowel cleansing. Group and release forms
Thank you
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.
Magnesia instructions
The instructions that accompany each package of Magnesia contain all the information necessary for the patient on its use and dosage regimen. Here you can read about the dosage forms of Magnesia and its composition, as well as read the indications for treatment.
In addition to the fact that the accompanying sheet contains information that warns about contraindications and side effects, there is guidance for use by various categories of patients.
If the drug Magnesia is prescribed for treatment, these instructions are required to be read.
Packaging and release form
The drug Magnesia is available in various dosage forms.
Magnesia powder
The drug in powder form is supplied to pharmacies packaged in ten, twenty or twenty-five grams. Magnesia powder is used to prepare the suspension.
Magnesia in ampoules
The drug in the form of a 25% solution is supplied to pharmacies in ampoules of five or ten milliliters. Each package contains ten ampoules.
Magnesia – magnesium sulfate
Magnesia, otherwise called magnesium sulfate or Epsom salt, does not contain impurities or auxiliary substances and consists only of magnesium salt of sulfuric acid. The drug is known for its effectiveness. Magnesia has been successfully used in gynecological, neurological, gastroenterological and many other medical fields.
The drug has a wide spectrum of action:
- Dilates blood vessels;
- Produces an analgesic effect;
- Has a relaxing effect on the smooth muscles of the uterus;
- Has an anticonvulsant effect;
- Eliminates arrhythmia;
- Has a weak diuretic effect;
- Is a sedative;
- Has a choleretic effect;
- Relaxes.
However, it should be taken into account that the manifestation of the properties of Magnesia directly depends on the method of entering the drug into the patient’s body.
Orally
Within half an hour after taking the drug in the form of a suspension, a laxative and choleretic effect may occur, which can last up to six hours. The suspension can also be used to achieve a mild diuretic effect, since its excretion is partially carried out by the kidneys.
Also, the Magnesia drug in this dosage form can be used as an antidote to mercury, lead, barium salts and arsenic.
Intravenously and intramuscularly
Administration of the drug by intravenous or intramuscular injection can provide anticonvulsant and sedative effects, as well as dilate blood vessels and eliminate arrhythmia. However, if the drug is administered in large doses, a tocolytic, hypnotic and narcotic-like effect can be caused.
The drug administered intramuscularly begins to show its effectiveness after about an hour, followed by a duration of up to four hours. Intravenous administration provides an immediate effect, however, its duration is no more than half an hour.
Electrophoresis
Magnesia solution is used for therapeutic procedures, such as electrophoresis, medicinal baths and compresses, which are applied topically to the wound surface of the skin. Such sessions are indicated to achieve a calming and vasodilating effect. Sometimes warts are treated this way.
Locally
With compresses and dressings using Magnesia, tissue blood flow improves and an analgesic and absorbable effect is achieved.
Magnesia indications
The drug is indicated for use by those patients who need help with the following diseases and conditions:
- With cerebral edema;
- For encephalopathy;
- For epilepsy;
- For eclampsia;
- If there is a threat of miscarriage or premature birth;
- In a state of magnesium deficiency in the blood;
- For ventricular arrhythmias, when the concentration of magnesium and potassium in the blood is too low;
- With excessive nervous excitability; (epilepsy, increased mental and motor activity, seizures);
- To eliminate excessive sweating;
- For hypotonic dyskinesias of the bile excretion pathways;
- For cholecystitis;
- For duodenal intubation;
- If you have bronchial asthma;
- In case of poisoning with any type of heavy metals;
- If constipation occurs;
- With urinary retention;
- For the treatment of warts and wound surfaces.
Contraindications
The drug Magnesia has a number of contraindications that must be taken into account when prescribing it for treatment. So, it is not advisable to prescribe Magnesia to those patients who have a similar diagnosis:
- With arterial hypotension;
- With atrioventricular block;
- With severe bradycardia;
- If depression of the respiratory center occurs;
- For women during the postpartum period;
- If you have appendicitis;
- In a condition with severe renal failure;
- If there is rectal bleeding;
- In a state of dehydration;
- In the presence of intestinal obstruction.
Magnesia instructions for use
When the drug is prescribed as an anticonvulsant, as well as for hypertension and heart rhythm disorders, it is used by intramuscular or intravenous injection.
Magnesia intramuscularly
Magnesia is administered intramuscularly in the form of a 25% solution, which does not require additional dilution. This method of taking the drug is usually accompanied by painful sensations.
Magnesia intravenously
Magnesia is administered intravenously, both in the form of an undiluted ready-made solution, and using its dilution with a solution of sodium chloride or glucose 5%. However, given the fact that complications can occur with rapid simultaneous administration of the drug, the injection solution is almost always diluted.
A maximum of 200 milliliters of a 20% solution can be used per day to administer Magnesia to a patient by any injection route.
Magnesia for children
In childhood, Magnesia is used mainly to treat constipation. Reception is carried out in the form of a suspension, which is obtained from the powder by diluting it in half a glass of warm water.
- Children from 6 to 12 years old are prescribed from 6 to 10 grams per day;
- children from 12 to 15 years old are prescribed 10 grams per day;
- adolescents over 15 years of age are prescribed from 10 to 30 grams per day.
The dose of the drug can be determined independently as follows: 1 year multiplied by 1 gram. For example, for an eight-year-old child, a dose of eight grams should be determined.
Medicinal enemas may also be prescribed to treat constipation. To prepare them, you need to take 30 grams of Magnesia powder and mix it with half a glass of warm water after boiling it. The resulting solution in the amount required by age (from 50 to 100 milliliters) is administered to the anus.
When there is an urgent need to relieve an emergency condition (severe asphyxia or intracranial hypertension), the child may be prescribed the drug intravenously or intramuscularly.
Magnesia during pregnancy
When a pregnant woman is at risk of miscarriage or there is a risk of premature birth, she is prescribed Magnesia to help relax the smooth muscles of the uterus.
The prescription involves administering the drug by injection with the obligatory condition that the woman is in the hospital under medical supervision. Since the drug has the ability to pass the placental barrier, medical personnel will monitor the condition of the fetus during its administration.
By slowly injecting a solution of Magnesia into a pregnant woman, swelling can be reduced due to the fact that the drug has a diuretic effect.
Magnesia injections
For many years, the drug Magnesia was considered one of the ideal remedies for the treatment of tetanus. In addition, it was used for anesthesia. This is due to the fact that the drug is capable of activating the effect of narcotic substances on the body.
When the drug was used only by injection, its administration was practiced in various ways: subcutaneously, intramuscularly, intravenously, and even into the spinal canal.
Subcutaneous injections
The most ineffective method of administering the drug is also quite painful and can lead to a lot of complications. This method is practically not used in treatment.
Intramuscular injections
A more effective method of injection treatment. The dosage for such administration of the drug is 0.5 g of Magnesia per kilogram of the patient’s weight.
Intravenous injections
One of the most effective methods of treatment with the drug. However, its use is fraught with fatal complications, so it is practically not used.
Intralumbar (injections into the spinal canal)
An effective method of treatment, however, it can also cause severe consequences for the patient.
Side effects
The drug Magnesia in any of its dosage forms has the ability to cause side effects during treatment in the patient, which can be expressed by the following symptoms:
- Depression of cardiac activity;
- State of bradycardia;
- Decreased blood pressure;
- The occurrence of arrhythmia;
- The occurrence of flushes to the face;
- Increased sweating;
- CNS depression;
- State of asthenia;
- Headaches;
- The emergence of an anxious state;
- Confusion;
- Decreased body temperature;
- Attacks of nausea and vomiting;
- State of polyuria;
- Diarrhea;
- Flatulence;
- Feeling of intense thirst;
- The occurrence of pain of a spastic nature.
Drug interactions
When simultaneous treatment with Magnesia by injection with other drugs, the following effects may be observed:
- Peripheral muscle relaxants - the effect of these drugs is enhanced;
- Nifedipine – may cause severe muscle weakness;
- Anticoagulants, cardiac glycosides, phenothiazine - the effectiveness of these medications decreases;
- Ciprofloxacin – the antibacterial ability of the drug increases;
- Streptomycin – the antibacterial ability of the drug decreases;
- Tetracycline antibiotics - their effect decreases and absorption from the gastrointestinal tract decreases.
When prescribing, you should also take into account the incompatibility of Magnesia with certain elements: calcium, barium, strontium, and also arsenic salts, carbonates, phosphates and bicarbonates of alkali metals, procaine hydrochlorides, tartrates, salicylates are not suitable for simultaneous administration. Do not use in combination with medications such as Clindamycin and Hydrocortisone.
Pharmacodynamics
When administered parenterally, it has anticonvulsant, antiarrhythmic, antihypertensive, antispasmodic effects; in large doses, it inhibits neuromuscular transmission, has a tocolytic effect, and suppresses the respiratory center.
Magnesium is a “physiological” calcium antagonist (blocking “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), which leads to inhibition of neuromuscular transmission. Relaxes the smooth muscles of internal organs, uterus and blood vessels, reduces blood pressure (BP) (mostly elevated), increases diuresis.
Anticonvulsant action. 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 the sodium current, the slow incoming calcium current and the one-way potassium current.
Tocolytic action. Magnesium inhibits the contractility of the myometrium (by reducing the absorption, binding and distribution of calcium ions in smooth muscle cells), increases blood flow in the uterus as a result of the dilation of its vessels.
It is an antidote for poisoning with heavy metal salts.
Systemic effects develop almost instantly after intravenous administration.
Duration of action when administered intravenously is 30 minutes.
Pharmacokinetics
When administered intravenously, the anticonvulsant effect develops immediately, and after intramuscular administration within 1 hour. The duration of the effect is about 30 minutes when administered into a vein and 3-4 hours when administered intramuscularly.
The concentration of magnesium ions in blood plasma normally averages 0.84 mmol/l, 25–35% of this amount is in a protein-bound state. Penetrates well through the placenta and blood-brain barrier; in milk it creates concentrations 2 times higher than concentrations in plasma.
It is excreted in the urine (at the same time increasing diuresis) by filtration; the rate of renal excretion is proportional to plasma concentration. 93–99% of magnesium is reabsorbed in the proximal and distal renal tubules.
Indications for use
Arterial hypertension (including hypertensive crisis with symptoms of cerebral edema);
- hypomagnesemia;
- polymorphic ventricular tachycardia (pirouette type);
- eclampsia (to suppress seizures) and preeclampsia (to prevent seizures in severe preeclampsia);
- tetany of the uterus;
- poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead).
Contraindications
Myasthenia;
- bradycardia;
- severe arterial hypotension;
- hypocalcemia;
- prenatal period (2 hours before birth);
- severe renal dysfunction (creatinine clearance less than 20 ml/min);
- hypersensitivity and hypermagnesemia;
- atrioventricular block of 1–3 degrees;
- depression of the respiratory center.
Directions for use and doses
Intravenously(slow jet or drip). The patient should be in a supine position.
Intramuscular therapy should only be used when intravenous administration of the drug is not possible, for example, when peripheral veins are not accessible.
There is very limited published data indicating that the concentration of magnesium sulfate solution for intramuscular administration should not exceed 200 mg/ml (20% solution).
Serum magnesium levels should be monitored before and during treatment. The dose of magnesium sulfate should be individualized depending on the patient's needs and response to treatment.
Serum magnesium levels >2.5 mmol/L should be avoided.
Doses of magnesium sulfate are indicated in grams, which corresponds to the amount of the drug: 1 g - 4 ml solution for intravenous and intramuscular administration 250 mg/ml (25% solution), 2 g - 8 ml, 3 g -12 ml, 4 g -16 ml , 5 g – 20 ml, 10 g – 40 ml, 15 g – 60 ml, 20 g – 80 ml, 30 g – 120 ml, 40 g – 160 ml solution for intravenous and intramuscular administration 250 mg/ml (25% solution ) respectively.
1 ml of the drug contains 1 mmol of magnesium.
A solution of magnesium sulfate can be diluted with a 0.9% sodium chloride solution or a 5% dextrose (glucose) solution.
Hypomagnesemia
Easy. A solution of magnesium sulfate is used parenterally if the oral route of administration of magnesium preparations is impossible or impractical (due to nausea, vomiting, impaired absorption in the stomach, etc.). The exact daily dose is 1–2 g (4–8 ml of solution for intravenous and intramuscular administration of 250 mg/ml).
This dose is administered once or in 2-3 doses.
Heavy. The initial dose is 5 g (20 ml of solution for intravenous and intramuscular administration of 250 mg/ml) slowly intravenously in 1 liter of infusion solution (0.9% sodium chloride solution or 5% dextrose (glucose) solution). Dosage depends on the content of magnesium ions in the blood serum.
With long-term use, monitoring of blood pressure, heart activity, tendon reflexes, kidney activity, and respiratory rate is recommended. If it is necessary to simultaneously administer calcium and magnesium salts, the drugs should be injected into different veins.
When treating deficiency conditions, care must be taken to avoid excessive renal excretion of magnesium and the occurrence of hypermagnesemia.
Prophylactic use during parenteral nutrition
The maintenance dose used in adults ranges from 1 g to 3 g (4–12 ml of solution for intravenous and intramuscular administration of 250 mg/ml) per day.
For infants and children, the range of maintenance doses is from 0.25 g to 1.25 g (1-5 ml of solution for intravenous and intramuscular administration of 250 mg/ml) per day.
Heart rhythm disturbance: 1–2 g (4–8 ml of solution for intravenous and intramuscular administration of 250 mg/ml) over 5 minutes. Re-introduction is possible.
At paroxysmal atrial tachycardia the drug should only be used if conventional measures are ineffective and there is no myocardial damage. The usual dose is 3–4 g (12–16 ml of solution for intravenous and intramuscular administration of 250 mg/ml) administered slowly intravenously with extreme caution.
For barium poisoning the usual dose of the drug is 1–2 g (4–8 ml of solution for intravenous and intramuscular administration of 250 mg/ml) intravenously.
Like an antidote Magnesium sulfate is used for poisoning with mercury, arsenic, tetraethyl lead, 5 ml of solution intravenously in a stream.
Tocolysis: initial dose of 4 g (16 ml of solution for intravenous and intramuscular administration of 250 mg/ml) intravenously, then 1–2 g/hour.
For relief of seizures, associated with epilepsy, glomerulonephritis, the usual dose for adults is 1 g (4 ml of solution for intravenous and intramuscular administration of 250 mg/ml) intramuscularly or intravenously.
During hypertensive crises 1–5 g (5–20 ml of solution for intravenous and intramuscular administration of 250 mg/ml) are administered intravenously (slowly over about 5 minutes!).
To relieve arrhythmias 1–2 g (4–8 ml of solution for intravenous and intramuscular administration of 250 mg/ml) are administered intravenously over about 5 minutes. To do this, 10 ml of solution is diluted in 200 ml of 5% glucose solution or potassium polarizing mixture. Re-introduction is possible.
Preeclampsia and eclampsia. The dose is set individually depending on the clinical situation. Saturation dose – 2–4 g (8–16 ml of solution for intravenous and intramuscular administration of 250 mg/ml) after 5–20 minutes (infusion). Maintenance dose of 1–2 g (4–8 ml of solution for intravenous and intramuscular administration of 250 mg/ml) per hour.
During treatment late toxicosis, preeclampsia and eclampsia use the administration of the drug according to Richard's scheme: initially 4.0 g (16 ml of solution for intravenous and intramuscular administration of 250 mg/ml) intravenously slowly over 3–4 minutes, after 4 hours repeat intravenous administration in the same dose and additionally administer 5, 0 g (20 ml of solution for intravenous and intramuscular administration of 250 mg/ml). Subsequently, intramuscular administration of magnesium sulfate in a dose of 4.0–5.0 g (16–20 ml of solution for intravenous and intramuscular administration of 250 mg/ml) is repeated every 4 hours. Instead of Richard's scheme, intravenous drip administration of 5.0 g of magnesium sulfate (20 ml of solution for intravenous and intramuscular administration of 250 mg/ml) diluted in 400 ml of 0.9% sodium chloride solution or 5% glucose solution at a rate of 9–25 mg is possible /min (15–40 drops/min). In the treatment of preeclampsia and eclampsia, an effective anticonvulsant effect is achieved with a serum magnesium level of 1.6–3.3 mmol/l. A serum magnesium level of 2.64 mmol/L is considered optimal for seizure control.
The maximum daily dose should not exceed 30–40 g of magnesium sulfate.
If renal function is impaired, no more than 20 g of magnesium sulfate per 48 hours.
Uterine tetany. Saturation dose – 4 g (16 ml of solution for intravenous and intramuscular administration of 250 mg/ml) after 20 minutes (infusion). Maintenance dose - first 1-2 g (4-8 ml of solution for intravenous and intramuscular administration 250 mg/ml) per hour, later - 1 g (4 ml of solution for intravenous and intramuscular administration 250 mg/ml) per hour (can be administered drip 24–72 hours).
Use in children
Treatment and prevention of hypomagnesemia
Newborns: daily dose – 50–100 mg/kg (0.2–04 ml/kg) intravenously and intramuscularly.
Children: 25–50 mg/kg magnesium sulfate intramuscularly or intravenously every 4–6 hours. The maximum single dose is 2000 mg.
For intravenous administration to children and infants, it is recommended to use a solution of magnesium sulfate 10 mg/ml. The solution is administered intravenously over 1 hour.
In severe cases, half the dose may be administered over the first 15–20 minutes.
If necessary, it is permissible to use a solution of magnesium sulfate 30 mg/ml for intravenous administration in children.
For intramuscular injection in children, it is recommended to use a solution diluted to a concentration of 200 mg/ml (20% solution).
Use in elderly patients
Dosages of magnesium sulfate in elderly patients are determined by the degree of renal dysfunction.
Side effect
Bradycardia, conduction disturbances;
- feeling of hot flashes, sweating;
- hypotension, weakness, headache;
- deep sedation, inhibition of tendon reflexes;
- shortness of breath;
- nausea, vomiting;
- polyuria.
Interaction with other drugs
When used together, it enhances the effect of other drugs that depress the nervous system (alcohol, psychotropic drugs, hypnotics, antiparkinsonian drugs, anticonvulsants). When used together with barbiturates, narcotic analgesics, and antihypertensive drugs, the likelihood of depression of the respiratory center increases.
Cardiac glycosides increase the risk of developing conduction disorders and atrioventricular block when used together with magnesium sulfate.
Aminoglycoside antibiotics, nifedipine and muscle relaxants can enhance the neuromuscular blockade caused by magnesium salts.
Intravenous administration of calcium salts weakens the effect of magnesium sulfate.
With the simultaneous administration of magnesium sulfate with other vasodilators, their hypotensive effect is enhanced.
Pharmaceutically incompatible (forms a precipitate) with calcium preparations, alcohol (in high concentrations), carbonates, bicarbonates and phosphates of alkali metals, salts of arsenic acid, barium, strontium, clindamycin phosphate, hydrocortisone succinate, polymyxin B sulfate, procaine, salicylates and tartrates.
Precautionary measures
Magnesium sulfate should be used carefully to avoid toxic concentrations of the drug.
Elderly patients a reduced dose should usually be used as they have reduced renal function.
Patients with impaired renal function(creatinine clearance more than 20 ml/min) and oliguria should not receive more than 20 g of magnesium sulfate (81 mmol Mg 2+) 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), blood pressure, monitoring is necessary tendon reflexes.
When administering magnesium sulfate, it is necessary to have a calcium solution prepared for intravenous administration, for example, a 10% solution of calcium gluconate.
When using magnesium sulfate, the results of radiological studies for which technetium is used may be distorted.
With long-term use monitoring of central hemodynamic parameters, monitoring of blood pressure, cardiac activity, tendon reflexes, respiratory rate and renal function is required.
If necessary, simultaneous administration of calcium and magnesium sulfate preparations, they should be injected into different veins.
During laboratory monitoring of plasma magnesium levels It should be borne in mind that normal plasma magnesium levels do not exclude its deficiency in tissues, because the concentration of magnesium in plasma and its level in the intercellular fluid are not always interrelated.
Magnesia or magnesium sulfate is a liquid injection drug that is produced in glass ampoules and is administered intravenously to the patient for a large number of different diseases. The main composition of this medicine is magnesium salt, obtained after a chemical reaction of the decomposition of sulfuric acid. The medication does not contain any additional substances or auxiliary components. Their presence is not provided for according to the pharmacological formula of the drug. The effectiveness of intravenous magnesium has been proven as a result of a large number of laboratory studies and during practical application in such branches of medicine as gynecology, gastroenterology, cardiology, and neurology.
After introducing Magnesia into a vein, the positive therapeutic effect appears within 1-2 minutes. Depending on the disease for which the use of this drug was indicated, the patient experiences appropriate relief. The molecules of the drug immediately mix with the flow of venous blood and in a matter of seconds spread throughout the body, saturating the epithelial tissues of vital organs and systems.
The spectrum of action of Magnesia is due to its following influence on the patient’s health and pharmacological properties:
- vasodilator (manifests itself in a sharp decrease in blood pressure, bronchial lumens expand, blood flow in the main vessels is stabilized);
- antispasmodic (due to this therapeutic property of the drug, an analgesic effect is achieved, which is especially important for inflammatory tissue lesions);
- tocolytic (provides complete relaxation of the smooth muscle fibers of the uterus, which is necessary to stabilize labor in women in the last stage of pregnancy);
- antiarrhythmic with regulation of the intensity of contraction of the heart muscle;
- a diuretic with a weakly expressed effect (for a more accelerated outflow of excess fluid from the body, it is recommended to use Magnesia in combination with other diuretic drugs);
- a sedative, which gently soothes irritated nerve endings in any part of the body;
- choleretic and laxative (this property affects the functioning of the entire digestive system, appetite improves, food is absorbed faster, metabolism accelerates).
Large dosages of Magnesia, or its intravenous administration over a long period of time, have a hypnotic and narcotic effect on humans. In general, the drug can rightfully be called an effective remedy for most diseases. Intravenous injections are used as the main medicine for the pathology identified in the patient, or are included in the course of general therapy.
Indications for intravenous magnesium use
Like any other drug, regardless of its degree of effectiveness, Magnesia has a number of indications for its administration into a patient’s vein on an ongoing basis or during an exacerbation of the disease. In general, injection injections are prescribed to a patient if he has the following pathological conditions of the body:
- acute swelling of the cerebral cortex with or without disruption of its vital centers;
- encephalopathy of varying severity (a prerequisite is a preliminary computed tomography scan of the brain);
- epileptic seizures and other similar conditions of the nervous system, expressed in the patient’s manifestation of convulsions, loss of consciousness, involuntary relaxation of the bladder muscles;
- the threat of premature birth when a pregnant woman is kept in the inpatient department of obstetrics and gynecology;
- ventricular arrhythmias associated with impaired activity of the heart muscle;
- renal dysfunction associated with urinary retention;
- chronic or acute cholecystitis without the formation of gallstones;
- treatment of warts that are viral in origin;
- therapy of deep wounds with a long healing period, bedsores, and infiltrates;
- intoxication of the body with salts of heavy metals (mercury, lead, tin, molybdenum, chromium);
- bronchial asthma of allergic etiology;
- constipation of all types.
In most cases, these are people whose bodies are severely depleted and require systemic drug support with artificial saturation of tissues with vitamins and minerals.
Contraindications
Despite the wide range of useful therapeutic properties of the drug and its versatility, there are a number of contraindications to its use. It is strictly forbidden to use Magnesia to treat patients who have the following concomitant diseases:
- chronic arterial hypotension;
- disruption of the conduction of neural impulses from the atria to the ventricles of the heart muscle;
- persistent bradycardia with prolapse of heart rhythm or without such disruptions;
- depressed state of the center of the brain responsible for the respiratory act;
- rectal bleeding (the cause of the pathology does not matter, the fact of acute blood loss itself is important);
- acute renal failure with accumulation of intoxication effect from nitrogenous compounds;
- intestinal obstruction of all types;
- appendicitis, requiring urgent surgical intervention with removal of the caecum;
- disturbance of water-salt balance and dehydration of the body.
Based on the results of a comprehensive examination, the attending physician may discover other pathologies in the patient that will be a direct contraindication to intravenous administration.
Instructions for using magnesia in ampoules
Is it possible to drink Magnesia in ampoules? The answer is clear - the drug is intended only for the purpose of its introduction into the vein cavity. A special suspension of magnesium sulfate is produced for oral use. In order to effectively use an intravenous drug, you must strictly adhere to simple rules for using the drug. They look like this:
- Take 1 ampoule of Magnesia 25% with a volume of 5 or 10 ml, depending on the prescribed single dosage.
- Open the glass ampoule and draw its liquid contents into a disposable syringe with a division scale of up to 20 ml.
- Dilute a pure solution of magnesium sulfate in ampoules with sodium chloride or glucose with a 5% concentration. The ratio of components can be 1 to 1 or in smaller proportions (it is not recommended to introduce magnesium salts of sulfuric acid into the blood in a pure, undiluted form, since the development of a number of complications cannot be ruled out).
- Insert the syringe needle into the vein cavity and slowly release the medicinal solution (before performing therapeutic procedures, be sure to release any remaining air and lubricate the surface of the skin with sterile cotton wool moistened with ethyl alcohol).
The drug can be administered into the veins by injection with single injections or in the form of systemic droppers, which contain Magnesium, saline solution or glucose in equal proportions. The dosage is determined individually by the attending physician, depending on the type of disease diagnosed. In most cases, one intravenous injection per day is sufficient to provide the patient with satisfactory well-being and a positive therapeutic effect.
Instructions
on medical use of the drug
Magnesium sulfate
Tradename
Magnesium sulfate
International nonproprietary name
Dosage form
Solution for intravenous administration 250 mg/ml, 10 ml
Compound:
1 ml of the drug contains:
active substance: magnesium sulfate - 250.0 mg
excipient: water for injection - up to 1.0 ml
Description
clear colorless liquid
Pharmacotherapeutic group
Plasma replacement and perfusion solutions. Electrolyte solutions
ATS code: B05ХА05
Pharmacological properties
Pharmacokinetics Systemic effects develop almost instantly after intravenous administration, duration of action is 30 minutes.
Equilibrium concentration (C SS) is 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 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 dilatation of its vessels.
It is an antidote for poisoning with heavy metal salts.
Systemic effects develop almost immediately after intravenous administration. The duration of action when administered intravenously 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; to relieve strong uterine contractions)
Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead)
Hypomagnesemia (including increased need for magnesium and acute hypomagnesemia with tetany).
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 per 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 slowly intravenously.
In adults. Mild hypomagnesemia. A solution of magnesium sulfate 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.).
Severe hypomagnesemia. The initial dose is 5 g. The dose is poured into 1 liter of infusion solution and administered slowly 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 magnesium sulfate solution 250 mg/ml is administered intravenously (slowly!!).
To relieve arrhythmias, 1-2 g are administered intravenously over about 5 minutes, possibly repeated administration.
Doses of magnesium sulfate are indicated in grams.
They correspond to the amount of solution: 1 g - 4 ml (250 mg/ml); 2 g - 8 ml (250 mg/ml); 3 g - 12 ml (250 mg/ml); 4 g - 16 ml (250 mg/ml); 5 g - 20 ml (250 mg/ml); 10 g - 40 ml (250 mg/ml); 15 g - 60 ml (250 mg/ml); 20 g - 80 ml (250 mg/ml); 30 g - 120 ml (250 mg/ml); 40 g - 160 ml (250 mg/ml).
A solution of magnesium sulfate in ampoules is diluted with injection solutions: 0.9% sodium chloride or 5% dextrose (glucose).
Side effects
Slowing down your breathing rate
Acute circulatory failure
Weakening of reflexes
Hyperemia
Arterial hypotension
Hypothermia
Weakening muscle tone
Uterine atony
Hyperhidrosis
Anxiety
Severe drowsiness (sedation)
Polyuria
Decrease in heart rate
Changes in the electrocardiogram (prolongation of the PQ interval and widening of the QRS complex)
Paralysis of the respiratory center
Early signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden flushing, 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).
Contraindications
Hypersensitivity to the drug
Atrioventricular block I-III degree (AV block)
Severe renal failure (if creatinine clearance is less than 20 ml/min)
Severe arterial hypotension
Conditions associated with calcium deficiency
Depression of the respiratory center
Severe respiratory diseases
Bradycardia
Prenatal period (2 hours before birth)
Menstruation.
Carefully: myasthenia gravis, chronic renal failure (if creatinine clearance is more than 20 ml/min), respiratory diseases, acute inflammatory diseases of the gastrointestinal tract, old age, pregnancy, lactation, 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).
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 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 Mg 2+) during
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.
Pregnancy
Magnesium sulfate penetrates the placenta, so long-term therapy (more than 3 weeks of daily use) during pregnancy with this drug contributes to the leaching of calcium from the fetus and the development of congenital rickets.
During pregnancy, magnesium sulfate is used only in cases where the expected therapeutic effect outweighs the potential risk to the fetus. If necessary, use during lactation should stop breastfeeding.
Features of the effect of the drug on the ability to drive vehicles and especially dangerous mechanisms
During the treatment period, driving and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions are not allowed.
Overdose
Symptoms: disappearance of the knee reflex, nausea, vomiting, sharp decrease in blood pressure, bradycardia, respiratory depression and central nervous system.
Treatment: a solution of calcium chloride or calcium gluconate should be slowly administered intravenously - 5-10 ml of 10%, oxygen therapy, carbogen inhalation, artificial respiration, peritoneal dialysis or hemodialysis, and symptomatic therapy should be performed.
Release form and packaging
Solution for intravenous administration 250 mg/ml.
10 ml in neutral glass ampoules. 10 ampoules with instructions for use and an ampoule scarifier in a cardboard box.
5 or 10 ampoules are placed in a blister pack made of polyvinyl chloride film or polyethylene terephthalate tape.
1 (10 ampoules each) or 2 (5 ampoules each) blister packs along with instructions for medical use in the state and Russian languages and an ampoule scarifier in a cardboard pack.
