What is the role of magnesium sulfate in the treatment of status asthmaticus?

Updated: Jun 17, 2020
  • Author: Constantine K Saadeh, MD; Chief Editor: John J Oppenheimer, MD  more...
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Intravenous magnesium sulfate infusion has been advocated in the past for the treatment of acute asthma. Magnesium can relax smooth muscle and hence may cause bronchodilation by competing with calcium at calcium-mediated smooth muscle ̶ binding sites. Usually 1 gram or a maximum of 2.5 grams during the initiation of therapy may be considered.

One double-blind, placebo-controlled study reported a significant increase in PEF, FEV1, and forced vital capacity in children who had asthma and were treated with a single 40-mg/kg dose of magnesium sulfate infused over 20 minutes, along with steroids and inhaled bronchodilators, compared with control subjects who received saline placebo. [36] In addition, patients who received intravenous magnesium (8 of 16 patients) were significantly more likely to be discharged home from the presenting emergency department than were control subjects (0 of 14 patients).

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