Magnesium Sulfate in the Treatment of Asthma

Gregory S. Martin, MD, MSc

Disclosures

August 09, 2004

Question

What is the role of intravenous magnesium sulfate in the treatment of asthma?

Nayyar Manzoor, DTCD, FCPS

Response From the Expert

Gregory S. Martin, MD, MSc

Response from Greg S. Martin, MD, MSc
Assistant Professor, Emory University School of Medicine, Atlanta, Georgia

This question is highly relevant given the prevalence of asthma and the severity with which exacerbation may occur. There is a reasonable amount of epidemiologic information that shows that magnesium may play a role in the control of asthma or in the development of bronchospasm. Dietary magnesium intake has been shown to be an independent factor contributing to bronchospasm in a general adult population.[1] Magnesium may play a role in the pathogenesis of asthmatic attacks, in cases in which intracellular magnesium stores have been shown to be reduced.[2] However, there does not appear to be any role for magnesium supplementation in chronic stable asthma.[3,4]

Among asthmatics with an acute exacerbation, intravenous (IV) administration of magnesium sulfate may improve bronchodilation and improve airflow.[5,6] For patients with the most severe airflow obstruction, IV magnesium sulfate appears to provide important clinical benefits, including a lower rate of hospital admission from the emergency department.[7] However, contradictory findings have been shown in other clinical trials.[8,9] Meta-analysis of these conflicting trials substantiates the benefit of IV magnesium sulfate for acutely ill asthmatic patients with severe exacerbation.[10] Given that IV magnesium is typically safe and well tolerated, its addition to an aggressive medical regimen for treatment of severe acute asthma exacerbations may be appropriate.

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