Clinical data | |
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Trade names | Epsom salt, others |
AHFS/Drugs.com | Monograph |
Routes of administration | IV, IM, by mouth, topical |
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Chemical and physical data | |
Formula | MgSO4 – 7H2O |
Molar mass | 120.366 |
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Magnesium sulfate as a medication is used to treat and prevent low blood magnesium and seizures in women with eclampsia. [1] It is also used in the treatment of torsades de pointes, severe asthma exacerbations, constipation, and barium poisoning. [1] [2] It is given by injection into a vein or muscle as well as by mouth. [1] [2] As epsom salts, it is also used for mineral baths. [3]
Common side effects include low blood pressure, skin flushing, and low blood calcium. [1] Other side effects may include vomiting, muscle weakness, and decreased breathing. [4] While there is evidence that use during pregnancy may harm the baby, the benefits in certain conditions are greater than the risks. [5] Its use during breastfeeding is deemed to be safe. [5] The way it works is not fully understood, but is believed to involve depressing the action of neurons. [1]
Magnesium sulfate came into medical use at least as early as 1618. [6] It is on the World Health Organization's List of Essential Medicines. [7] [8] In 2021, magnesium salts were the 211th most commonly prescribed medication, with more than 2 million prescriptions. [9] [10]
Magnesium sulfate is available as magnesium sulfate dihydrate, [11] magnesium sulfate heptahydrate, [2] [12] and magnesium sulfate monohydrate. [13]
The World Health Organization recommends magnesium sulfate heptahydrate for medical injection. [14]
Magnesium sulfate is used in bath salts, especially for foot baths to soothe sore feet. The reason for the inclusion of the salt is partially cosmetic: the increase in ionic strength prevents some of the temporary skin wrinkling (partial maceration) which would occur with plain water baths.
Epsom salt baths have been claimed to also soothe and hasten recovery of muscle pain, soreness, or injury. However, these claims have not been scientifically confirmed. [15] The solubility of magnesium sulfate water is inhibited by lipids in lotions resulting in variable absorption rates when applied to the skin. Temperature and concentration are also factors. [16]
Research on topical magnesium (for example epsom salt baths) is limited. [17]
Magnesium sulfate is commonly used in flotation therapy to prepare the concentrated solutions that fill the isolation tanks. Its high solubility in water yields baths with high specific gravity that make the body more buoyant. Its negligible toxicity is an important asset in that application.
Magnesium and sulfate ions are naturally present in some mineral waters. [18]
In the United Kingdom, a medication containing magnesium sulfate, called "drawing paste", is claimed to be useful for small boils or localised infections, [19] and removing splinters. [20] The standard British Pharmacopoeia composition is dried magnesium sulfate 47.76% (by mass), phenol 0.49%, and glycerol to balance. [19]
Magnesium sulfate can be administered internally by oral, respiratory, intravenous, or intrathecal routes.
Injected magnesium sulfate is used as a replacement therapy for magnesium deficiency. [21]
Orally administered magnesium sulfate is laxative and thus the magnesium is not well absorbed.
Magnesium sulfate may be used as an antiarrhythmic agent for torsades de pointes in cardiac arrest under the ECC guidelines and for managing quinidine-induced arrhythmias. [22]
Magnesium sulfate may be used as bronchodilator after beta-agonist and anticholinergic agents have been tried, e.g. in severe exacerbations of asthma, [23] The salt can be administered by nebulization [23] or by intravenous injection.
Magnesium sulfate is effective in decreasing the risk that pre-eclampsia progresses to eclampsia. [24] Intravenous magnesium sulfate is used to prevent and treat seizures of eclampsia. It reduces the systolic blood pressure but does not alter the diastolic blood pressure, so the blood perfusion to the fetus is not compromised. It is also commonly used for eclampsia where compared to diazepam or phenytoin it results in better outcomes. [25] [26]
Magnesium sulfate was once used as a tocolytic, [27] [28] but meta-analyses have failed to support it as an anti-contraction medication. [29] [30] Usage for prolonged periods (more than five to seven days) may result in health problems for the baby. [31]
In those at risk of an early delivery, magnesium sulfate appears to decrease the risk of cerebral palsy. [32] [ needs update ] [33] It is unclear if it helps those who are born at term. [34] Guidelines for the use of magnesium sulfate in mothers at risk of preterm labour are not strongly adhered to. [35]
Magnesium sulfate is used to treat barium chloride poisoning, [36] where sulfate binds to barium to form insoluble barium sulfate.
Magnesium sulfate was historically used as a treatment for lead poisoning. Prior to the development of chelation therapy, cases of accidental lead ingestion were often immediately treated with magnesium sulfate, which would cause the lead to be precipitated out and, with a high enough dose, literally purged from the digestive system as insoluble lead(II) sulfate. [37] [38] In this application, magnesium sulfate saw particular use in veterinary medicine of the early-to-mid 20th century; Epsom salt was already available on many farms for agricultural purposes, and it was often prescribed in the treatment of farm animals which inadvertently ingested lead. [39] [40]
Magnesium sulfate can be administered intrathecally with opioids to prolong their analgesic duration. [41]
Magnesium sulfate has been used as an experimental treatment of Irukandji syndrome caused by envenomation by certain species of Irukandji jellyfish, but the efficacy of this treatment remains unproven. [42]
An abnormally elevated plasma concentration of magnesium is called hypermagnesemia.
Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.
Iron(II) sulfate (British English: iron(II) sulphate) or ferrous sulfate denotes a range of salts with the formula FeSO4·xH2O. These compounds exist most commonly as the heptahydrate (x = 7) but several values for x are known. The hydrated form is used medically to treat or prevent iron deficiency, and also for industrial applications. Known since ancient times as copperas and as green vitriol (vitriol is an archaic name for sulfate), the blue-green heptahydrate (hydrate with 7 molecules of water) is the most common form of this material. All the iron(II) sulfates dissolve in water to give the same aquo complex [Fe(H2O)6]2+, which has octahedral molecular geometry and is paramagnetic. The name copperas dates from times when the copper(II) sulfate was known as blue copperas, and perhaps in analogy, iron(II) and zinc sulfate were known respectively as green and white copperas.
Magnesium sulfate or magnesium sulphate is a chemical compound, a salt with the formula MgSO4, consisting of magnesium cations Mg2+ (20.19% by mass) and sulfate anions SO2−4. It is a white crystalline solid, soluble in water but not in ethanol.
Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia is a hypertensive disorder of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of protein in the urine or other organ dysfunction, and edema. If left untreated, pre-eclampsia can result in long-term consequences for the mother, namely increased risk of cardiovascular diseases and associated complications. In more severe cases, it may be fatal for both the mother and the fetus.
Pre-eclampsia is a multi-system disorder specific to pregnancy, characterized by the onset of high blood pressure and often a significant amount of protein in the urine. When it arises, the condition begins after 20 weeks of pregnancy. In severe cases of the disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances. Pre-eclampsia increases the risk of undesirable as well as lethal outcomes for both the mother and the fetus including preterm labor. If left untreated, it may result in seizures at which point it is known as eclampsia.
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 28 and 32 weeks, early preterm birth occurs between 32 and 34 weeks, late preterm birth is between 34 and 36 weeks' gestation. These babies are also known as premature babies or colloquially preemies or premmies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes and/or the leaking of fluid from the vagina before 37 weeks. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and problems with their vision. The earlier a baby is born, the greater these risks will be.
Epsomite, Epsom salt, or magnesium sulfate heptahydrate, is a hydrous magnesium sulfate mineral with formula MgSO4·7H2O.
Barium sulfate (or sulphate) is the inorganic compound with the chemical formula BaSO4. It is a white crystalline solid that is odorless and insoluble in water. It occurs in nature as the mineral barite, which is the main commercial source of barium and materials prepared from it. Its opaque white appearance and its high density are exploited in its main applications.
Sodium sulfate (also known as sodium sulphate or sulfate of soda) is the inorganic compound with formula Na2SO4 as well as several related hydrates. All forms are white solids that are highly soluble in water. With an annual production of 6 million tonnes, the decahydrate is a major commodity chemical product. It is mainly used as a filler in the manufacture of powdered home laundry detergents and in the Kraft process of paper pulping for making highly alkaline sulfides.
Chlorhexidine is a disinfectant and antiseptic with the molecular formula C22H30Cl2N10, which is used for skin disinfection before surgery and to sterilize surgical instruments. It is also used for cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and to keep urinary catheters from blocking. It is used as a liquid or a powder. It is commonly used in salt form, either the gluconate or the acetate.
Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment. Inductions are most often performed either with prostaglandin drug treatment alone, or with a combination of prostaglandin and intravenous oxytocin treatment.
Bleomycin is a medication used to treat cancer. This includes Hodgkin's lymphoma, non-Hodgkin's lymphoma, testicular cancer, ovarian cancer, and cervical cancer among others. Typically used with other cancer medications, it can be given intravenously, by injection into a muscle or under the skin. It may also be administered inside the chest to help prevent the recurrence of a pleural effusion due to cancer; however talc is better for this.
Atosiban, sold under the brand name Tractocile among others, is an inhibitor of the hormones oxytocin and vasopressin. It is used as an intravenous medication as a labour repressant (tocolytic) to halt premature labor. It was developed by Ferring Pharmaceuticals in Sweden and first reported in the literature in 1985. Originally marketed by Ferring Pharmaceuticals, it is licensed in proprietary and generic forms for the delay of imminent preterm birth in pregnant adult women.
Tocolytics are medications used to suppress premature labor. Preterm birth accounts for 70% of neonatal deaths. Therefore, tocolytic therapy is provided when delivery would result in premature birth, postponing delivery long enough for the administration of glucocorticoids, which accelerate fetal lung maturity but may require one to two days to take effect.
Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labor. Women usually experience a painless gush or a steady leakage of fluid from the vagina. Complications in the baby may include premature birth, cord compression, and infection. Complications in the mother may include placental abruption and postpartum endometritis.
Magnesium deficiency is an electrolyte disturbance in which there is a low level of magnesium in the body. It can result in multiple symptoms. Symptoms include tremor, poor coordination, muscle spasms, loss of appetite, personality changes, and nystagmus. Complications may include seizures or cardiac arrest such as from torsade de pointes. Those with low magnesium often have low potassium.
Iron supplements, also known as iron salts and iron pills, are a number of iron formulations used to treat and prevent iron deficiency including iron deficiency anemia. For prevention they are only recommended in those with poor absorption, heavy menstrual periods, pregnancy, hemodialysis, or a diet low in iron. Prevention may also be used in low birth weight babies. They are taken by mouth, injection into a vein, or injection into a muscle. While benefits may be seen in days, up to two months may be required until iron levels return to normal.
Calcium gluconate is the calcium salt of gluconic acid and is used as a mineral supplement and medication. As a medication it is used by injection into a vein to treat low blood calcium, high blood potassium, and magnesium toxicity. Supplementation is generally only required when there is not enough calcium in the diet. Supplementation may be done to treat or prevent osteoporosis or rickets. It can also be taken by mouth but is not recommended for injection into a muscle.
Magnesium salts are available as a medication in a number of formulations. They are used to treat magnesium deficiency, low blood magnesium, eclampsia, and several other conditions. Magnesium is an essential nutrient.
Migraine may be treated either prophylactic (preventive) or abortive (rescue) or acute. Because migraine is an complex condition, there are various preventive treatments which have their effect by disrupting different links in the chain of events that occur during a migraine attack. As rescue treatments also target and disrupt different processes occurring during migraine, these are summarized, with their relative merits and demerits.
Previous ACLS guidelines addressed the use of magnesium in cardiac arrest with polymorphic ventricular tachycardia (ie, torsades de pointes) or suspected hypomagnesemia, and this has not been reevaluated in the 2015 Guidelines Update. These previous guidelines recommended defibrillation for termination of polymorphic VT (ie, torsades de pointes), followed by consideration of intravenous magnesium sulfate when secondary to a long QT interval.
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: CS1 maint: unfit URL (link)The treatment of acute lead-poisoning consists in the evacuation of the stomach, if necessary, the exhibition of the sulphate of sodium or of magnesium, and the meeting of the indications as they arrive. The Epsom and Glauber's salts act as chemical antidotes, by precipitating the insoluble sulphate of lead, and also, if in excess, empty the bowel of the compound formed.
Udall (1) suggests sodium citrate as of some value together with Epsom salts which will bring about a precipitation of the lead in the form of an insoluble compound. Nelson (3) reported a case that survived following the use of a 20% magnesium sulphate solution intravenously, subcutaneously and orally. McIntosh (5) has suggested that purgative doses of Epsom salts may be effective in combining with the lead and overcoming the toxicity.
The specific antidotes to metal poisoning had not been discovered and the only thing which sometimes did a bit of good was magnesium sulphate which caused the precipitation of insoluble lead sulphate. The homely term for magnesium sulphate is, of course, epsom salts.