-
Computational Intelligence and... 2022This study is designed to explore the effect of compound Danshen injection combined with magnesium sulfate on TNF-, NO, oxidative stress, and therapeutic efficacy in... (Randomized Controlled Trial)
Randomized Controlled Trial
AIMS
This study is designed to explore the effect of compound Danshen injection combined with magnesium sulfate on TNF-, NO, oxidative stress, and therapeutic efficacy in severe preeclampsia (S-PE).
METHODS
Sixty S-PE patients were placed into the control group and the therapy group, randomly. The control group was under the treatment of magnesium sulfate, and the therapy group was under the treatment of compound Danshen injection with magnesium sulfate. After treatment, the therapeutic efficacy of the two groups was comparatively analyzed.
RESULTS
7 days after treatment, DBP, SBP, and 24 h urinary protein were sharply lower than those before treatment. The 24 h urinary protein was notably lower in the therapy group. After treatment, the expression level of TNF- in both groups was notably higher than before treatment, while NO level was higher than that before treatment. Furthermore, D-D level in two groups was dramatically decreased compared to that before treatment. Moreover, Fib, PT, and APTT in two groups showed statistically significant differences after 7 days. The contents of ALT, AST, BUN, and Scr in therapy group were notably lower than those in control group.
CONCLUSION
Our results indicated that compound Danshen injection could improve renal function, blood hypercoagulability, and oxidative stress level and had a better therapeutic effect on S-PE.
Topics: Female; Humans; Magnesium Sulfate; Oxidative Stress; Pre-Eclampsia; Pregnancy; Salvia miltiorrhiza; Tumor Necrosis Factor-alpha
PubMed: 35898773
DOI: 10.1155/2022/9789066 -
The Journal of Physiology Dec 2018Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute... (Review)
Review
Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia-ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia-ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia-ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.
Topics: Animals; Asphyxia; Fetal Hypoxia; Glucocorticoids; Humans; Hypoxia-Ischemia, Brain; Magnesium Sulfate
PubMed: 29774532
DOI: 10.1113/JP274949 -
Epilepsy Research 1989Magnesium sulfate has been used as an anticonvulsant in the treatment of eclampsia, but efficacy of magnesium in other types of seizure disorders is poorly documented....
Magnesium sulfate has been used as an anticonvulsant in the treatment of eclampsia, but efficacy of magnesium in other types of seizure disorders is poorly documented. We examined the effects of magnesium sulfate (MgSO4) on seizures produced in mice by maximal electroshock (MES) and pentylenetetrazol (PTZ), MgSO4 injection (6.7 mEq/kg i.p.) caused weakness in all animals. With suprathreshold electroshock, 10/10 controls and 11/12 treated animals had seizures with tonic hind limb extension (P = NS). Electroshock threshold was unaltered by magnesium treatment (n = 48; P = 0.47). PTZ induced clonic seizures in 12/12 controls and 5/14 treated animals (P less than 0.05). This difference was likely due to muscular weakness because frequency of EEG spikes was the same in PTZ and PTZ + MgSO4 groups. Mean serum magnesium levels were 2.3 +/- 0.3 mEq/l in animals not given MgSO4; 10.9 +/- 1.4 mEq/l and 12.8 +/- 2.2 mEq/l in treated animals with and without seizures (P = NS). We conclude that magnesium sulfate had no significant anticonvulsant activity in mouse MES and PTZ models for epilepsy. The relevance of these findings to the possible efficacy of magnesium sulfate in eclamptic seizures and other types of epilepsy remains to be determined.
Topics: Animals; Anticonvulsants; Infusions, Parenteral; Magnesium Sulfate; Male; Mice; Pentylenetetrazole; Seizures
PubMed: 2612492
DOI: 10.1016/0920-1211(89)90004-1 -
Journal of Clinical Pharmacology Mar 2019Magnesium sulfate is the standard therapy for prevention and treatment of eclampsia. Two standard dosing regimens require either continuous intravenous infusion or...
Magnesium sulfate is the standard therapy for prevention and treatment of eclampsia. Two standard dosing regimens require either continuous intravenous infusion or frequent, large-volume intramuscular injections, which may preclude patients from receiving optimal care. This project sought to identify alternative, potentially more convenient, but similarly effective dosing regimens that could be used in restrictive clinical settings. A 2-compartment population pharmacokinetic (PK) model was developed to characterize serial PK data from 92 pregnant women with preeclampsia who received magnesium sulfate. Body weight and serum creatinine concentration had a significant impact on magnesium PK. The final PK model was used to simulate magnesium concentration profiles for the 2 standard regimens and several simplified alternative dosing regimens. The simulations suggest that intravenous regimens with loading doses of 8 g over 60 minutes followed by 2 g/h for 10 hours and 12 g over 120 minutes followed by 2 g/h for 8 hours (same total dose as the standard intravenous regimen but shorter treatment duration) would result in magnesium concentrations below the toxic range. For the intramuscular regimens, higher maintenance doses given less frequently (4 g intravenously + 10-g intramuscular loading doses with maintenance doses of 8 g every 6 hours or 10 g every 8 hours for 24 hours) or removal of the intravenous loading dose (eg, 10 g intramusculary every 8 hours for 24 hours) may be reasonable alternatives. In addition, individualized dose adjustments based on body weight and serum creatinine were proposed for the standard regimens.
Topics: Adult; Female; Humans; Infusions, Intravenous; Injections, Intramuscular; Magnesium Sulfate; Pre-Eclampsia; Pregnancy
PubMed: 30422321
DOI: 10.1002/jcph.1328 -
The Cochrane Database of Systematic... Jul 2007Persistent pulmonary hypertension of the newborn (PPHN) occurs in approximately 1.9 per 1000 newborns and may be more frequent in developing countries. There is strong... (Review)
Review
BACKGROUND
Persistent pulmonary hypertension of the newborn (PPHN) occurs in approximately 1.9 per 1000 newborns and may be more frequent in developing countries. There is strong evidence for the use of inhaled nitric oxide (iNO) and extra corporeal membrane oxygenation (ECMO) in the treatment of PPHN. However, many developing countries do not have access or the technical expertise required for these expensive therapies. Magnesium sulfate is a potent vasodilator and hence has the potential to reduce the high pulmonary arterial pressures associated with PPHN. If magnesium sulfate were found to be effective in the treatment of PPHN, this could be a cost effective and potentially life-saving therapy.
OBJECTIVES
To evaluate the use of magnesium sulfate compared with placebo or standard ventilator management alone, sildenafil infusion, adenosine infusion, or inhaled nitric oxide on mortality or the use of backup iNO or ECMO in term and near-term newborns (> 34 weeks gestational age) with PPHN.
SEARCH STRATEGY
The standard search strategy of the Cochrane Neonatal Review Group (CNRG) was used. No language restrictions was applied. The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2006) and MEDLINE (1966 to April 20, 2007) were searched for relevant randomized and quasi-randomized trials. In addition the reference lists of retrieved articles were reviewed and known experts were contacted to obtain unpublished data.
SELECTION CRITERIA
All randomised or quasi-random studies were eligible where one of the treatment groups received magnesium sulfate for PPHN.
DATA COLLECTION AND ANALYSIS
Standard methods of the Cochrane Collaboration and the CNRG were used, including independent assessment of trial quality and extraction of data by each author.
MAIN RESULTS
No eligible trials were found
AUTHORS' CONCLUSIONS
On the basis of the current lack of evidence, the use of magnesium sulphate cannot be recommended in the treatment of PPHN. Randomised controlled trials are recommended.
Topics: Humans; Infant, Newborn; Magnesium Sulfate; Persistent Fetal Circulation Syndrome; Vasodilator Agents
PubMed: 17636807
DOI: 10.1002/14651858.CD005588.pub2 -
Medicine Jun 2019To compare the clinical efficacy and safety of phloroglucinol (PHL) and magnesium sulfate (MS) in the treatment of threatened abortion through systematic review. (Comparative Study)
Comparative Study Meta-Analysis
BACKGROUND
To compare the clinical efficacy and safety of phloroglucinol (PHL) and magnesium sulfate (MS) in the treatment of threatened abortion through systematic review.
METHODS
Foreign databases, such as the Cochrane Library, PubMed and EMBASE, and Chinese databases, including the China Biology Medicine disc (SinoMed), China National Knowledge Infrastructure (CNKI), Chongqing VIP (VIP) and WanFang Data, were searched. Published randomized controlled trials (RCTs) documents obtained from these databases were included if they were associated with the research objective. The search timeframe was from the beginning of the establishment of each database to May 2018. Document selection, data abstraction and document quality evaluation were independently performed by 2 investigators. A combined analysis of the data was performed for those documents that fulfilled the study requirements; Rev Man 5.3 and Stata 12.0 software were used to compare and analyze the 2 drugs in terms of the total effective rate (TER), rate of adverse events, time required to relieve uterine contractions, onset time, time of complete relief of uterine contraction symptoms, medication duration and length of hospital stay.
RESULTS
A total of 21 RCT trials were included in the present research, according to the inclusion criteria. However, the quality of the included studies was low. The meta-analysis suggested that the TER and drug onset time of PHL were higher than those for MS, while the rate of adverse events, the time required to relieve uterine contractions, time to complete relief of uterine contraction symptoms, drug continuous treatment time and length of hospital stay were shorter than those for MS.
CONCLUSION
The clinical efficacy of PHL is better than that of MS, and PHL obviously results in fewer adverse reactions than MS. However, due to poor quality of evidence, high quality, multi-center RCTs with large samples are required for further verification.
Topics: Abortion, Threatened; Female; Humans; Magnesium Sulfate; Phloroglucinol; Pregnancy; Randomized Controlled Trials as Topic; Reproductive Control Agents
PubMed: 31192955
DOI: 10.1097/MD.0000000000016026 -
The Cochrane Database of Systematic... 2000Treatment of acute asthma is based on rapid reversal of bronchospasm and arresting airway inflammation. There is some evidence that intravenous magnesium can provide... (Review)
Review
BACKGROUND
Treatment of acute asthma is based on rapid reversal of bronchospasm and arresting airway inflammation. There is some evidence that intravenous magnesium can provide additional bronchodilation when given in conjunction with standard bronchodilating agents and corticosteroids. No systematic review of this literature has been completed on this topic.
OBJECTIVES
To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.
SEARCH STRATEGY
Randomised controlled trials were identified from the Cochrane Airways Review Group register. Bibliographies from included studies, known reviews and texts were searched. Primary authors and content experts were contacted.
SELECTION CRITERIA
Randomised controlled trials or quasi-randomised trials were eligible for inclusion. Studies were included if patients presented with acute asthma and were treated with IV magnesium sulfate vs placebo.
DATA COLLECTION AND ANALYSIS
Data were extracted and methodological quality was assessed independently by two reviewers. Missing data were obtained from authors.
MAIN RESULTS
Seven trials were included (5 adult, 2 pediatric). A total of 665 patients were involved. Patients receiving magnesium sulfate demonstrated non-significant improvements in peak expiratory flow rates when all studies were pooled (weighted mean difference: 29.4 L/min; 95% confidence interval: -3.4 to 62). In studies of people with severe acute asthma, peak expiratory flow rate improved by 52.3 L/min (95% confidence interval: 27 to 77.5). The forced expiratory volume in one second also improved by 9.8 % predicted (95% confidence interval: 3.8 to 15.8). Overall, admission to hospital was not reduced, odds ratio: 0.31 (95% confidence interval: 0.09 to 1.02). In the severe subgroup, admissions were reduced in those receiving magnesium sulfate (odds ratio: 0.10, 95% confidence interval: 0.04 to 0.27). No clinically important changes in vital signs or adverse side effects were reported.
REVIEWER'S CONCLUSIONS
Current evidence does not support routine use of intravenous magnesium sulfate in all patients with acute asthma presenting to the emergency department. Magnesium sulfate appears to be safe and beneficial in patients who present with severe acute asthma.
Topics: Acute Disease; Adrenal Cortex Hormones; Adult; Asthma; Bronchodilator Agents; Child; Drug Therapy, Combination; Emergency Service, Hospital; Humans; Infusions, Intravenous; Magnesium Sulfate
PubMed: 10796650
DOI: 10.1002/14651858.CD001490 -
Acta Ortopedica Mexicana 2017The distal radius fracture represent until 15% of all bone injuries in adults. The key in the recovery of mobility and functional outcomes are rehabilitation. The... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The distal radius fracture represent until 15% of all bone injuries in adults. The key in the recovery of mobility and functional outcomes are rehabilitation. The intra-articular application of magnesium sulphate has been used for postoperative pain. The objective was to determinate the improvement in pain and functional outcome of patients with distal radius fracture using intra-articular magnesium sulphate.
MATERIAL AND METHODS
Patients with distal radius fracture treated with percutaneous pinning and cast immobilization was included and randomized into two groups. The group 1 was applied 1.0 ml of magnesium sulphate and 1.5 ml of injectable water; meanwhile the group 2, the water was replaced with 1 ml of bupivacaine (5 mg/ml). The intra-articular infiltration was applied at the end of immobilization. Pain, functionality and movement of the wrist was evaluated for two weeks.
RESULTS
Twenty patients, 8 male and twelve females, with a mean age of 53 years (± 17 SD) was evaluated. A significative reduction of pain during the first minute and at three minutes after intra-articular infiltration in group 2 (p 0.05). Both groups presented better articular outcomes at the two weeks (p 0.05), and a better articular movement at same point (p 0.05).
CONCLUSIONS
The intra-articular infiltration of magnesium sulphate plus bupivacaine help to reduces the pain.
Topics: Adult; Analgesics; Bupivacaine; Female; Fracture Fixation, Internal; Humans; Magnesium Sulfate; Male; Middle Aged; Pain, Postoperative; Pilot Projects; Radius Fractures; Treatment Outcome
PubMed: 29518295
DOI: No ID Found -
Clinical pharmacokinetic properties of magnesium sulphate in women with pre-eclampsia and eclampsia.BJOG : An International Journal of... Feb 2016The pharmacokinetic basis of magnesium sulphate (MgSO4 ) dosing regimens for eclampsia prophylaxis and treatment is not clearly established. (Review)
Review
BACKGROUND
The pharmacokinetic basis of magnesium sulphate (MgSO4 ) dosing regimens for eclampsia prophylaxis and treatment is not clearly established.
OBJECTIVES
To review available data on clinical pharmacokinetic properties of MgSO4 when used for women with pre-eclampsia and/or eclampsia.
SEARCH STRATEGY
MEDLINE, EMBASE, CINAHL, POPLINE, Global Health Library and reference lists of eligible studies.
SELECTION CRITERIA
All study types investigating pharmacokinetic properties of MgSO4 in women with pre-eclampsia and/or eclampsia.
DATA COLLECTION AND ANALYSIS
Two authors extracted data on basic pharmacokinetic parameters reflecting the different aspects of absorption, bioavailability, distribution and excretion of MgSO4 according to identified dosing regimens.
MAIN RESULTS
Twenty-eight studies investigating pharmacokinetic properties of 17 MgSO4 regimens met our inclusion criteria. Most women (91.5%) in the studies had pre-eclampsia. Baseline serum magnesium concentrations were consistently <1 mmol/l across studies. Intravenous loading dose between 4 and 6 g was associated with a doubling of this baseline concentration half an hour after injection. Maintenance infusion of 1 g/hour consistently produced concentrations well below 2 mmol/l, whereas maintenance infusion at 2 g/hour and the Pritchard intramuscular regimen had higher but inconsistent probability of producing concentrations between 2 and 3 mmol/l. Volume of distribution of magnesium varied (13.65-49.00 l) but the plasma clearance was fairly similar (4.28-5.00 l/hour) across populations.
CONCLUSION
The profiles of Zuspan and Pritchard regimens indicate that the minimum effective serum magnesium concentration for eclampsia prophylaxis is lower than the generally accepted level. Exposure-response studies to identify effective alternative dosing regimens should target concentrations achievable by these standard regimens.
TWEETABLE ABSTRACT
Minimum effective serum magnesium concentration for eclampsia prophylaxis is lower than the generally accepted therapeutic level.
Topics: Anticonvulsants; Eclampsia; Female; Humans; Magnesium Sulfate; Pre-Eclampsia; Pregnancy
PubMed: 26599617
DOI: 10.1111/1471-0528.13753 -
American Family Physician Jun 2011
Topics: Anticonvulsants; Clinical Trials as Topic; Evidence-Based Medicine; Female; Humans; Magnesium Sulfate; Nimodipine; Phenytoin; Pre-Eclampsia; Pregnancy; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 21661707
DOI: No ID Found