magnesium in asthma: to use or not?

25 Sep

ROUGH IDEA:

Thought to inhibit Ca influx into smooth muscle.

 

Green SM, Rothrock SGIntravenous magnesium for acute asthma: failure to decrease emergency treatment duration or need for hospitalization.  Ann Emerg Med. 1992;21(3):260.

    • 120 patients, age 18-65 yo
    • all got 125mg methylprednisolone, 02, albuterol q1h
    • study group got magnesium 2 g IV over 20 min
    • hospitalization, length of ED treatment, peak flows were not significantly different

BOTTOM LINE: does not show magnesium helped more than just systemic glucocorticoids and duonebs.

 

Alter HJ, Koepsell TD, Hilty WM. Intravenous magnesium as an adjuvant in acute bronchospasm: a meta-analysis. Ann Emerg Med. 2000;36(3):191.

  • Combined results across 9 studies including 859 patients
  • beneficial in improving spirometric airway function by 16% of a SD
  • No serious adverse events were reported 
  • their conclusion: “Although the clinical significance of this is uncertain, given the safety of intravenous magnesium sulfate therapy and its relatively low cost, it should be considered, absent contraindications, in patients with moderate to severe acute bronchospasm.”

BOTTOM LINE: Showed that magnesium is somewhat beneficial.

 

TAKEAWAY:

  • relatively safe/few adverse events
  • may be helpful; at worst, no benefit.
  • worth considering for refractory asthma (to albuterol, steroids, etc).

 

Submitted by J. Rothstein.

 

ANOTHER RELATED POST.

 

MAGNESIUM (dosing/side effects) QUICK REFRESHER

 

References: you just saw ’em; picture

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