IV Magnesium

Does having Iv Magnesium infusions regularly cause any harm? I have been to A&E a few times in the past month and have been given it each time (before they have checked my u&e's)

Sarah

[KateMoss]

I don't know of any harm from long term use though it is short lived in my experience. It hoiks me out of a severe attack but then after about an hour I usually need IV ventolin on top.

Kate

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Ive read that it supposedly just helps clear the gunk out of your lungs than have any effect on the actual asthma???, I dont think it would be used on its own more in addition to nebs and IVs.

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Magnesium is thought to act more directly on the lung smooth muscle; at last reading I don't think anyone was entirely sure how it works, but everyone was in agreement that it certainly does. In many places now it's fairly high up on the protocol for treatment for acute asthma. As far as I know you don't become tolerant to it, and I don't know of any long-term effects/problems from having it regularly.

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This is a very interesting topic - IV magnesium is fascinating stuff!

As Cath says, IV magnesium is thought to act as a direct bronchodilator rather than just clearing secretions from the chest. It's very effective in some people (I know some people who describe it as their 'wonder drug') and less so in others.

The British Thoracic Society guidelines on managing acute attacks say that it should be used as a fourth line therapy if an acute attack fails to respond to steroids and nebulised salbutamol and ipratropium. They list it for use ahead of IV aminophylline, although some hospitals would still use IV aminophylline before magnesium if they are more familiar with it (my protocol lists IV aminophylline first as I know I respond better to it - I do respond to IV mag but only if I get it very early on in the attack, which given the speed that my attacks come on, only happens if I have one whilst already in hospital).

The HDU consultant (who is a respiratory consultant) at my local says that the literature only shows evidence of benefit in patients whose CO2 has started to climb, which would be in the late stages of a severe attack for most people. He will only usually use it in these circumstances, but A&E and the other consultants use it more readily.

The BTS states in the guidelines that repeated use in the same attack could potentially cause high magnesium levels, which can cause muscle weakness and worsen respiratory failure - I think this is a theorectical risk, though, and if someone has responded to magnesium initially but then got worse again, the benefits probably outweigh the risks. Personally, when I was working, I would not usually wait for the results of a patient's U&Es or magnesium level before giving the first dose, although I might if I was giving repeated doses. As a patient, when I was given a couple of doses in A&E, my magnesium would often be normal or low after this, and during most of my Intensive Care admissions I've been on a magnesium infusion, with careful monitoring of levels.

I don't know of any evidence at all that repeated administrations on separate occasions causes any harm at all. Last year I had either multiple doses or infusions on thirteen occasions and it didn't appear to have any adverse effect. Certainly, magnesium levels would not be expected to remain high for long after a dose, as the kidneys would quickly redress the balance by getting rid of the extra magnesium.

Hope this helps

Em

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i used to have iv magnesium but last time i was in i had an adverse reaction to it within minutes of the iv starting my heart rate shot up to over 200 and i felt very odd! this has never happened before but it always used to make me feel funny and make me tachycardic but that was put down to the iv amino and nebs. i never felt any better after having this anyway. i used to have it quite regularly before this and had no longterm effects of having it so often.

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IV Magnesium does indeed sound very interesting,thanks for posting EmilyH!

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Bringing to the top for Olive

Em

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bump for Sandi although not directly related to what your asking. it has some info about magnesium