magnesium sulfate: great NNT, ? mechanisms

6 Nov

from October’s EP Monthly article:


IV magnesium sulfate: to prevent hospital admission in severe asthmatics

  • NNT = 3


Mechanisms for…

  • concurrent hypokalemia
    • magnesium repletion is required to prevent renal excretion of potassium by inhibiting ROMK channels in the distal tubules
  • eclampsia
    • unclear but may be due to systemic or cerebral vasodilation
  • tocolytic
    • calcium antagonism
  • dysrhythmias
    • magnesium is required for functioning of the Na/K ATPase enzyme, and hypomagnesemia can lead to prolonged QT and PR.
  • severe asthma exacerbations,
    • bronchodilation, though the mechanism by which it produces this is not well established


References: epmonthly article,; picture


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