Magnesium Glycinate Complex 450 mg Tablets - Formulated for Calm, High Absorption, Muscle Relax & Gentle Digestion, Vegan, Non-GMO, Gluten-Free, Soy Free, Bioavailable, 180 Tablets
Magnesium sulfate: instructions for use
Pharmaceutical action
Magnesium is able to displace calcium from its binding sites, as it is a physiological calcium antagonist. Magnesium regulates metabolic processes, muscular excitability and neurochemical transmission, prevents the passage of Ca2 + ions through the presynaptic membrane, reduces the content of acetylcholine in the central and peripheral nervous system. The intracellular deficiency of Mg2 + ions provokes the development of ventricular arrhythmias. When injected, magnesium sulfate blocks the neuromuscular transmission (in large doses, the drug has curare-like properties) and prevents the development of seizures, dilates the peripheral vessels, reduces the pulse rate and slows down AV conductivity. Injections of low doses of magnesium sulfate cause only sweating and hot flashes, high doses cause a decrease in blood pressure.
Magnesium sulfate has a depressant effect on the central nervous system. Depending on the dose administered, sedative, hypnotic, and even general anesthetic effects can be observed.
Magnesium sulfate reduces the excitability of the respiratory center, large doses of the drug can lead to respiratory paralysis. Magnesium sulfate when poisoning with salts of heavy metals is an antidote.
Systemic effects with intramuscular injection develop after 1 hour, with intravenous administration almost instantly. The duration of the drug when administered intramuscularly is 3-4 hours, with the introduction of intravenous - about 30 minutes.
When used orally, the drug promotes the release of cholecystokinin, has a choleretic effect, irritates the duodenal receptors. Magnesium sulfate is poorly absorbed, not more than 20%, increases the osmotic pressure in the gastrointestinal tract, retains fluid and, by a concentration gradient, facilitates its release into the intestinal lumen, increasing peristalsis in all intestinal sections, 4 to 6 hours after ingestion leads to defecation. The absorbed part of magnesium is excreted by the kidneys, and diuresis increases. The drug passes through the placenta and the blood-brain barrier, is found in breast milk, and its content is 2 times higher than in the mother's blood plasma.
Indications
For injection: hypertensive crisis (including with signs of swelling of the brain); encephalopathy; eclampsia; hypomagnesaemia, including for prevention (unbalanced or inadequate nutrition, diuretics, contraceptive use, chronic alcoholism, muscle relaxants); acute hypomagnesemia (myocardial dysfunction, signs of tetany); increased need for magnesium (pregnancy, stress, recovery period, growth period, excessive sweating); the threat of preterm birth; convulsions during preeclampsia; ventricular tachycardia type "pirouette"; ventricular arrhythmias that are associated with an increase in the QT interval; the occurrence of arrhythmias at low plasma concentrations of magnesium or / and potassium; urine retention; epileptic syndrome; poisoning with salts of heavy metals (arsenic, mercury, lead).
For oral administration: constipation; cholecystitis; gallbladder dyskinesia of hypotonic type (for tubing); cholangitis; bowel cleansing before diagnostic procedures; duodenal intubation (to obtain a cystic portion of bile); poisoning with salts of heavy metals (arsenic, mercury, barium, lead).
Contraindications
Hypersensitivity, hypermagnesia. Additionally for injections: arterial hypotension, severe bradycardia, depression of the respiratory center, AV blockade, prenatal period (2 hours before delivery), severe renal failure (with creatinine clearance less than 20 ml / min). Additionally for oral administration: appendicitis, intestinal obstruction, rectal bleeding (including intended), dehydration.
Dosing
Magnesium sulfate is injected intramuscularly, intravenously, taken orally. Intravenously (slowly, the first 3 ml - enter 3 minutes) or intramuscularly - 5–20 ml of a 20–25% solution every 1-2 times a day. In case of poisoning with arsenic, mercury, tetraethyl lead - intravenous 5–10% solution of 5–10 ml. To relieve convulsions in children intramuscularly 20–40 mg / kg (or 0.1–0.2 ml / kg of a 20% solution). The maximum dose of magnesium sulfate is 40 g / day (160 mmol / day).
Inside: as a laxative (on an empty stomach or for the night) adults - 10–30 g in half a glass of water, children —1 g for 1 year of life; for cholagogue - 1 tablespoon of a 20–25% solution 3 times a day; for duodenal sounding, 100 ml of 10% solution or 50 ml of 25% solution is injected through a probe.
Poisoning with soluble barium salts: wash the stomach with 1% magnesium sulfate solution or take it inside with 200 ml of water 20-25 g.
With prolonged treatment with magnesium sulfate, it is recommended to monitor the work of the heart, blood pressure, tendon reflexes, respiratory rate, kidney function. If it is necessary to simultaneously use intravenous calcium and magnesium preparations, then they should be injected into different veins. Patients with severely impaired renal function should not receive more than 20 g of magnesium sulfate for 2 days; also the patient (and also patients with oliguria) should not be given intravenous magnesium sulfate too quickly.
Side effects
When administered parenterally: the symptoms and signs of hypermagnesemia - diplopia, bradycardia, flushing, hypotension, sweating, depression of the central nervous system and heart, with a content of Mg2 + 2-3.5 mmol / l in the blood - a decrease in deep tendon reflexes; 2.5–5 mmol / l - expansion of the QRS complex and prolongation of the PQ interval on the ECG; 4–5 mmol / l - the absence of deep tendon reflexes; 5–6,5 mmol / l - depression of the respiratory center; 7.5 mmol / l - disturbances of cardiac conduction; 12.5 mmol / l - cardiac arrest. Hypothermia, atony of the uterus, weakness, headache, anxiety, hypocalcemia with signs of secondary tetany can also develop. With a very high plasma concentration of magnesium (which can occur, for example, with a very fast intravenous drug, with renal failure): polyuria, paresthesia, nausea, vomiting.
When ingestion: nausea, diarrhea, vomiting, exacerbation of inflammatory diseases of the digestive system, thirst, spastic abdominal pain, flatulence, electrolyte imbalance (asthenia, fatigue, confusion, convulsions, arrhythmia), symptoms and signs of hypermagnesium (especially in the presence of renal failure).
Interaction
The use of nephrotoxic drugs such as cisplatin, amphotericin B, gentamicin, cyclosporin, increases the need for magnesium. Thiazide and loop diuretics with prolonged use can reduce the magnesium-preserving function of the kidneys, this can lead to hypomagnesemia (control of the content of magnesium in the blood is necessary). Potassium-sparing diuretics with prolonged use increase the reabsorption of magnesium in the kidneys, this can lead to the development of hypermagnesia, especially in patients with renal insufficiency. Calcium salts (for intravenous administration) relieve the effects of magnesium sulphate used parenterally. But calcium chloride or calcium gluconate is used in hypermagnesia to eliminate toxic effects. The combined use of oral calcium supplements and magnesium sulfate can cause an increase in serum magnesium or calcium, especially in patients with renal insufficiency. The deprivation effect on the central nervous system with parenteral use of magnesium sulfate is enhanced when combined with drugs that have a depressant effect on the central nervous system. There is information about the development of hypomagnesemia in patients who simultaneously used digitalis glycosides and magnesium sulfate, and this can cause digitalis intoxication. When administered orally together, magnesium sulfate may reduce the absorption and content of glycosides in the blood in digitalis. Muscle relaxants increase neuromuscular blockade when taken together with magnesium sulfate. Magnesium sulfate reduces the absorption of tetracyclines, etidronovoy acid. Excessive glucose or alcohol increases the renal excretion of magnesium.
special instructions
Restrictions on the use of
For injections: myasthenia gravis, respiratory diseases, chronic renal failure and other disorders of the kidneys, acute inflammatory diseases of the gastrointestinal tract.
For oral administration: myocardial damage, heart block, chronic renal failure.
Use during pregnancy and lactation
If there is a need to use magnesium sulfate during lactation, then breastfeeding should be stopped. Animal studies using magnesium sulfate have not been carried out. It is not known whether magnesium sulfate has an adverse effect on the fetus or whether the drug affects the reproductive capacity. Therefore, use magnesium sulfate during pregnancy only if necessary.
With parenteral use during eclampsia in pregnant women, the drug quickly penetrates the placenta and in fetal blood serum reaches approximately the same concentration as that of the mother. In newborns, the effects of magnesium sulfate are similar to those of the mother and may include hyporeflexia, respiratory depression, hypotension, if the woman received magnesium sulfate before delivery. Therefore, usually in the prenatal period (2 hours before delivery) magnesium sulfate is not used, except in cases when it is necessary to prevent convulsions during eclampsia. Magnesium sulfate can be administered continuously intravenously at a rate of 1–2 g every hour, provided that the patient is carefully monitored (plasma magnesium concentration, blood pressure, respiratory rate, deep tendon reflexes).
Overdose
In case of an overdose of magnesium sulfate when administered parenterally, there are: the disappearance of the knee jerk (the classic clinical symptom of the onset of intoxication), nausea, a sharp decrease in blood pressure, bradycardia, vomiting, depression of the central nervous system and respiration.
Necessary: as an antidote, calcium preparations (calcium gluconate or calcium chloride 5–10 ml 10%), intravenous inhalation of carbogen, oxygen therapy, artificial lung ventilation, hemodialysis or peritoneal dialysis, symptomatic therapy (correcting the cardiovascular and central nervous system) are slowly administered intravenously. ).
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