Universal reference book for medicines
Product name: MAGNESIUM SULFATE (MAGNESIUM SULFATE)

Active substance: magnesium sulfate

Type: Magnesium-containing drug

Manufacturer: ИВАНОВСКАЯ Фармацевтическая Фабрика (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
When ingestion has cholagogue (reflex action on the receptors of the duodenal mucosa) and laxative effect (due to poor absorption of the drug in the intestine it creates a high osmotic pressure, there is an accumulation of water in the intestine, the contents of the intestine liquefy, the peristalsis intensifies).
It is an antidote for poisoning with salts of heavy metals. The onset of the effect is 0.5-3 hours, duration - 4-6 hours.
When parenteral administration has an antihypertensive, calming and anticonvulsant effect, as well as diuretic, arteriodilating, antiarrhythmic, vasodilating (on arteries) action, in high doses - curare (depressing effect on neuromuscular transmission), tocolytic, hypnotic and narcotic effect, suppresses respiratory Centre.Magnesium is a physiological blocker of slow calcium channels and is able to displace it from binding sites.
Regulates metabolic processes, interneuronal transmission and muscular excitability, prevents the entry of calcium through the presynaptic membrane, reduces the amount of acetylcholine in the peripheral nervous system and the central nervous system. Relaxes smooth muscles, reduces blood pressure (mostly increased), increases diuresis.
The mechanism of anticonvulsant action is associated with a decrease in the release of acetylcholine from neuromuscular synapses, while magnesium suppresses neuromuscular transmission, has a direct inhibitory effect on the central nervous system.

The antiarrhythmic effect of magnesium is due to a decrease in the excitability of cardiomyocytes, the restoration of ionic equilibrium, the stabilization of cell membranes, the violation of sodium current, a slow incoming calcium current and a unilateral potassium current.
The cardioprotective effect is due to the expansion of the coronary arteries, the decrease in OPSS and platelet aggregation.
The tocolytic action develops as a result of inhibition of the contractile ability of the myometrium (decrease in absorption, binding and distribution of calcium in smooth muscle cells) under the influence of the magnesium ion, increasing blood flow in the uterus as a result of the expansion of its vessels.
Magnesium is an antidote for poisoning with salts of heavy metals.
Systemic effects develop almost instantaneously after IV and 1 hour after IM.
The duration of action with / in the introduction - 30 minutes, with / m - 3-4 hours.
PHARMACOKINETICS
After ingestion, no more than 20% of the dose taken is absorbed.

C ss , at which the anticonvulsant effect develops, is - 2-3.5 mmol / l.

It penetrates the GEB and the placental barrier, is excreted in breast milk with a concentration that is 2 times higher than the concentration in the plasma.
It is excreted by the kidneys, the rate of renal excretion is proportional to the concentration in the plasma and the level of glomerular filtration.
INDICATIONS
For oral administration: constipation, cholangitis, cholecystitis, dyskinesia of the gallbladder according to the hypotonic type (for carrying out tjubazhes), duodenal sounding (for obtaining a vesicle bile of bile), cleansing of the intestine before diagnostic manipulation.

For parenteral administration: arterial hypertension (including hypertensive crisis with brain edema phenomena), hypomagnesemia (including increased need for magnesium and acute hypomagnesemia - tetany, impaired myocardial function), polymorphic ventricular tachycardia (such as "pirouette" ), urine retention, encephalopathy, epileptic syndrome, threat of premature birth, seizures with gestosis, eclampsia.

Poisoning with salts of heavy metals (mercury, arsenic, tetraethyl lead, barium).

DOSING MODE
Individual, depending on the indications and the dosage form used.
Intended for oral, intramuscular and / or (slow) injection, via a duodenal probe.
SIDE EFFECT
Early signs and symptoms of hypermagnesemia: bradycardia, diplopia, sudden rush of blood to the face, headache, decreased blood pressure, nausea, shortness of breath, blurred speech, vomiting, weakness.

Signs of hypermagnesium (in order of increasing the concentration of magnesium in the serum): a decrease in deep tendon reflexes (2-3.5 mmol / l), prolongation of the PQ interval and expansion of the QRS complex on the ECG (2.5-5 mmol / l), loss of deep tendon reflexes (4 -5 mmol / l), inhibition of the respiratory center (5-6.5 mmol / l), cardiac conduction disorder (7.5 mmol / l), cardiac arrest (12.5 mmol / l);
in addition - hyperhidrosis, anxiety, pronounced sedation, polyuria, atony of the uterus.
Ingestion: nausea, vomiting, diarrhea, exacerbation of inflammatory diseases of the digestive tract, electrolyte imbalance (fatigue, asthenia, confused consciousness, arrhythmia, convulsions), flatulence, abdominal pain of a spastic nature, thirst, signs of hypermagnesia in the presence of kidney failure (dizziness) .

CONTRAINDICATIONS
Chronic renal failure of a serious degree, hypersensitivity to magnesium sulfate.

For oral administration: appendicitis, rectal bleeding (including undiagnosed), intestinal obstruction, dehydration.

For parenteral administration: arterial hypotension, respiratory center depression, pronounced bradycardia, AV blockade, pre-natal period (2 hours prior to delivery).

PREGNANCY AND LACTATION
In pregnancy magnesium sulfate is used with caution, only in cases where the expected therapeutic effect exceeds the potential risk to the fetus.

If it is necessary to use lactation, breastfeeding should be discontinued.

APPLICATION FOR FUNCTIONS OF THE LIVER
Contraindicated in chronic renal failure severe.
C with caution taken or administered parenterally in chronic kidney failure.
SPECIAL INSTRUCTIONS
C with caution taken or administered parenterally with heart block, myocardial damage, chronic renal failure, respiratory diseases, acute inflammatory diseases of the digestive tract, pregnancy.

Magnesium sulfate can be used to arrest epileptic status (as part of a comprehensive treatment).

When an overdose causes CNS depression.
As an antidote for an overdose of magnesium sulfate, calcium-calcium chloride or calcium gluconate preparations are used.
DRUG INTERACTION
With parenteral application of magnesium sulfate and simultaneous use of muscle relaxants of peripheral action, the effects of muscle relaxants of peripheral action increase.

With the simultaneous ingestion of antibiotics from the tetracycline group, the effect of tetracyclines may decrease due to a decrease in their absorption from the gastrointestinal tract.

A case of stopping breathing with the use of gentamycin in an infant with an elevated magnesium concentration in the blood plasma against the background of magnesium sulfate therapy is described.

At simultaneous application with nifedipine the expressed muscular delicacy is possible.

Reduces the effectiveness of oral anticoagulants (including coumarin derivatives or derivatives of indanedione), cardiac glycosides, phenothiazines (especially chlorpromazine).
Reduces the absorption of ciprofloxacin, etidronic acid, weakens the effects of streptomycin and tobramycin.
As an antidote for an overdose of magnesium sulfate used drugs calcium - calcium chloride or calcium gluconate.

Pharmaceutically incompatible (precipitate) with preparations of Ca 2+ , ethanol (in high concentrations), carbonates, bicarbonates and phosphates of alkali metals, salts of arsenic acid, barium, strontium, clindamycin phosphate, hydrocortisone sodium succinate, polymyxin In sulfate, procaine hydrochloride, salicylates and tartrates.

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