MAGNESIUM SULPHATE

By Natalia Oliveira

INTRODUCTION
Magnesium sulfate is an inorganic salt and it is often encountered as, commonly called Epsom salt. (bathing salt)

As a bronchodilator in severe exacerbations of asthma.

It can delay pre-term labor Intravenous magnesium sulfate has been shown to prevent cerebral palsy in pre term babies

Solutions of sulfate salts such as Epsom salt may be given as first aid for barium chloride poisoning.
In gardening and agriculture, magnesium sulfate is used to correct a magnesium or sulfur deficiency in soil

Magnesium sulfate can be used to treat eclampsia in pregnant women.

ECLAMPSIA

Is defined as the appearance of seizures in pregnant women with pre eclampsia It was the leading cause of maternal mortality worldwide and remains one of the most severe obstetric complications in our midst.

It used to be treated with maternal bleeding or termination of the pregnancy

HISTORY

The idea to use Mg2+ for the management of eclamptogenic dates from before 1955 when it was tested and published In 1955, Pritchard described the intramuscular treatment regimen for eclampsia and pre - eclampsia using a loading MgSO4 dose. On 1995, The eclamptic Trial Collaborative Group, developed a systematic review of anticonvulsants for women with preeclampsia Following this review in 2002, the Magpie Trials was launched.

HOW DOES IT WORK:

The only cure for eclampsia is still the birth of the fetus.

Women are diagnosed during pregnancy and treated with Magnesium serum. MgSO4 can prevent seizures, which would lead the mother to a coma.
Intramuscular Regimen: 4g intravenous, followed by 10g intramuscular + 5g intramuscular each 4 hours Intravenous Regimen: 4g, followed by 1 to 2g/h controlled infusion pump. Although its exact mechanism of action is unclear, some studies have suggested that magnesium sulfate could act as a vasodilator. Magnesium sulfate is nearly entirely broken down in the body, with 90 percent of the compound being released through the urine within 24 hours.

A SUCCESS OR A FAILURE?

Was little used in many countries, before the results of the Collaborative Eclampsia Trial There did not appear to be substantive harmful effects to mother or baby in the short term

highly affordable (US$0.35 per ampoule)

Incremental cost of preventing one case of eclampsia was $21,202 in high, $2473 in middle, and $456 in low-income countries as measured by GNI. Highly effective - sulphate was proven remarkably effective at reducing the risk of eclampsia, whether this is the first seizure or recurrence of convulsions

A SUCCESS OR A FAILURE?

Magnesium sulfate has not achieved widespread usage in developing countries. Lack of public awareness of the drug, lack of adequate serviceprovider training, and lack of availability of magnesium sulfate in these areas Widespread in the United States, Europe and South America Magnesium sulfate is rarely globally manufactured because its low cost leaves little profit-based incentive for pharmaceutical companies to produce it.

CONCLUSION

As to lack of public awareness of the drug, adequate serviceprovider training, and availability of magnesium sulfate in such areas, it is needed a platoon of information and awareness about this drug in less developed countries that could benefit from an affordable and efficient solution for high mortality rate of woman by eclampsia in less developed countries The results of this trial should be made available to women with pre-eclampsia and those responsible for their care. Given its safety, effectiveness, and low cost, it is imperative that a concerted effort must be made to educate healthcare workers and to make this intervention available to every facility caring for pregnant women.

In areas where magnesium sulphate is already used extensively, investigators might just want to adjust dosing schedules or run trials to determine if a different dose brings more benefit.

REFERENCES

Magpie Trial Collaboration Group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 2002; 359(9321):1877-90.
http://www.sogesp.com.br/recomendacoes-sogesp/2012/tema-02-uso-dosulfato-de-magnesio-no-tratamento-da-pre-eclampsia-e-da-eclampsia

http://www.sogesp.com.br/recomendacoes-sogesp/2012/tema-02-uso-dosulfato-de-magnesio-no-tratamento-da-pre-eclampsia-e-da-eclampsia
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHu manMedicalProducts/ucm354603.htm http://www.ncbi.nlm.nih.gov/pubmed/17166220

BJOG - An International Journal of Obstetrics and Gynaecology, 2006;113: 144-151)

https://stroke.ahajournals.org/content/40/4/1169.full http://en.wikipedia.org/wiki/Magnesium_sulfate

http://www.drugs.com/pro/magnesium-sulfate.html