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Magnesium sulphate...what's next?

Hi,

Just wondered if any of you out there have found that after a few times of being given magnesium sulphate that its not as effective as it was to begin with?

What have u bern given instead?

I will discuss this with my cons at my next appointment but wondered if this is usual.

Thanks,

X

7 Replies
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I take it we are talking Magnesium during an attack given by IV in hospital! I have times when it is not as effective, sometimes I need a couple of doses over the course of a few hours followed by several hours/days of Aminophylline. Magnesium is generally the preferred method for treating Asthma during an emergency situation, to be followed with an Aminophylline infusion is unusual, but is done for me because generally without it I relapse. Aminophylline can be used instead of Magnesium as a first option, but considered quite old fashioned, and can take longer to have effect in the first place.

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well i was in this situation only the other day!

i took an attack on Saturday, was given the usuall back to back nebs, iv hydro and iv magnesium (which usually sorts me right out!) but it made no difference to me this time at all!! i was then put on Iv Aminophyllin and moitored very closely for the next few hours till it kicked in.

When i saw my consultant the next day he said that he thought that the reason the magnesium didnt work could have been due to the fact that the attack was so severe that the magnesium just couldnt relax the muscles enough or it could also be due to the fact that i have had Magnesium for every attack recently and my body had just gotten a bit too used to it.

my cons view is that he would always want magnesium to be tried as if it works it will work quickly where as the aminophyllin as said above can take a bit of time.

Hope that wasnt too confusing a reply!

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Thanks becca, that all makes perfect sense!

They did mention the aminophillin (exc spelling) but decided to try a few more back to back nebs as the mag sulph partly worked, good to know what the next step is as I did panic wondering what happens as like you mag sulph is normally my wonder drug!! :-)

Hope your lungs qre recovering x

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This has happened to me. IV Magnesium used to be my wonder drug, I used to feel so much better after having it and didn't need anything else. Now it's only part of my treatment regime, I always have IV magnesium first, then move onto IV aminophylline and IV salbutamol.

(IV aminophylline now isn't as effective for me as it used to be, I don't like getting used to medications so this happens!)

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Katina - how odd but your reply to me has only just shown on here so please don't think I was ignoring you!!

Thanks for the info and to you too glitterdust, its reassuring ti hear other people's experiences as the fact the mag sulph didn't work as well this time kind of freaked me out a bit....

Katina this was during an attack on Monday when I was in resus :-S

Thanks all for the info, you are all as usual a font of all knowledge :-D

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Does anyone know of an alternative to aminophylline. I've been banned from having it due to heart problems caused. Nearly ended up intubated because hospital didn't know what to do when magnesium didn't work (after nebs, iv steroids,iv salbutamol). Luckily I managed this time but wondered if you experienced guys knew of an alternative option to itu tubing.

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theres IV salbutamol or IV terbutline (less side effects than IV salbutamol) or adrenaline but with all asthma meds used in attacks they all cause tachycardia. NIV in the form of Bipap can be an alternative the the actual tubing

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