0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Magnesium Sulfate in Exacerbations of Chronic Obstructive Pulmonary Disease

Morton S. Skorodin, MD; Michael F. Tenholder, MD; Barbara Yetter, PharmD; Kathryn A. Owen, RRT; Rita F. Waller, RRT; Sharad Khandelwahl, MD; Kevin Maki, MS; Tahir Rohail, MD; Nausica D'Alfonso, MD
Arch Intern Med. 1995;155(5):496-500. doi:10.1001/archinte.1995.00430050072008.
Text Size: A A A
Published online

Background:  Acute exacerbations of chronic obstructive pulmonary disease are commonly seen and difficult to treat. We sought to determine the bronchodilator efficacy of magnesium sulfate in this situation, as this compound is helpful in acute asthma.

Methods:  Subjects who came to either of two Veterans Affairs emergency departments were randomized in a double-blind fashion to receive either 1.2 g of magnesium sulfate or placebo over 20 minutes after they first received albuterol, 2.5 mg by nebulization. Peak expiratory flow, dyspnea scores, arterial hemoglobin oxygen saturation by pulse oximetry, maximal inspiratory and expiratory pressures, and vital signs were monitored for 45 minutes after the start of magnesium sulfate or placebo treatment.

Results:  Seventy-two individuals were studied. The peak expiratory flow increased 16.6%±27.7% (mean±SD) in both groups after the initial albuterol treatment, from 121.2±55.7 L/min to 136.9±63.9 L/min. The peak expiratory flow increased from 136.7±69.7 L/min at the start of the infusion to 162.3±76.6 L/min at 30 minutes and 161.3±78.7 L/min at 45 minutes with magnesium sulfate treatment. The peak expiratory flow was 137.0±58.6 L/min on initiation of the intravenous infusion, 143.0± 72.7 L/min at 30 minutes, and 143.3±70.5 L/min at 45 minutes in the placebo group. The difference in peak expiratory flow from initiation of the infusion to 30 and 45 minutes later (calculated as means of the 30- and 45-minute values) was significantly different for the two groups (25.1±35.7 L/min vs 7.4±33.3 L/min; P=.03); the difference was also significant when expressed as percentage increase (22.4%±28.5% vs 6.1%±24.4%; P=.01). There was a statistically nonsignificant trend toward a reduced need for hospitalization in the magnesium sulfate group as compared with the placebo group (28.1% vs 41.9%; P=.25). There were no significant changes in the other parameters with either treatment.

Conclusions:  Magnesium sulfate, 1.2 g over 20 minutes after β-agonist administration, is safe and modestly efficacious in the treatment of acute exacerbations of chronic obstructive pulmonary disease, and its bronchodilator effect is greater than that of a β-agonist given alone and lasts beyond the period of magnesium sulfate administration.(Arch Intern Med. 1995;155:496-500)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 22

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();