Magnesium sulfate (medical use)

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Magnesium sulfate
Magnesium sulfate.JPG
Magnesium sulfate heptahydrate
Clinical data
Trade names Epsom salt, others
AHFS/Drugs.com Monograph
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
Formula MgSO4 - 7H2O
Molar mass 120.366
3D model (Jmol)

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]

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. 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 completely known 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 0.35 to 8.73 USD 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 USD.[1]

Medical uses[edit]

Eclampsia[edit]

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[edit]

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]

Bath salts[edit]

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.[18] The claimed health benefits of Epsom Salt baths have not been proven.[19]

Research[edit]

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.[20]

References[edit]

  1. ^ a b Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 220. ISBN 9781284057560. 
  2. ^ a b c d e f "Magnesium Sulfate". The American Society of Health-System Pharmacists. Retrieved 8 January 2017. 
  3. ^ a b c d e 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. 
  5. ^ WHO Model Formulary 2008 (PDF). World Health Organization. 2009. p. 75. ISBN 9789241547659. Retrieved 8 January 2017. 
  6. ^ "Magnesium sulfate Use During Pregnancy | Drugs.com". www.drugs.com. 
  7. ^ Willett, Edward (2006). Magnesium. The Rosen Publishing Group. p. 5. ISBN 9781404210073. 
  8. ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. 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. Retrieved 2009-07-06. 
  11. ^ Lewis DF (September 2005). "Magnesium sulfate: the first-line tocolytic". Obstet. Gynecol. Clin. North Am. 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. Retrieved 2 June 2013. 
  15. ^ Doyle, LW; Crowther, CA; Middleton, P; Marret, S; Rouse, D (Jan 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 (Feb 2012). "Treatment with magnesium sulphate in pre-term birth: a systematic review and meta-analysis of observational studies.". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 32 (2): 135–40. doi:10.3109/01443615.2011.638999. PMID 22296422. 
  17. ^ Nguyen, TM; Crowther, CA; Wilkinson, D; Bain, E (Feb 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. ^ "Bath - Hot Springs". Retrieved 16 October 2016. 
  19. ^ Ingraham, Paul. "Does Epsom Salt Work? The science of Epsom salt bathing for recovery from muscle pain, soreness, or injury". Pain Science. Retrieved 29 August 2016. 
  20. ^ Corkeron M (2003). "Magnesium infusion to treat Irukandji syndrome". Med J Aust. 178 (8): 411. PMID 12697017.