Mg in COPD

Q: Intravenous Magnesium (IV Mg) can be given in severe exacerbation of COPD? (select one)

A) as a bolus

B) over 20 minutes

C) over an hour

D) as continuous infusion

Answer: B

Magnesium sulfate has a Grade C recommendation for use as an adjuvant treatment in severe COPD exacerbation, particularly when response to short-acting inhaled bronchodilators is not robust. A single dose of 2 grams IV Mg can be given over 20 minutes. IV Mg has bronchodilator activity. It inhibits calcium influx into the airway smooth muscle cells. It shows some evidence of decreased hospitalizations in COPD exacerbations.

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References:

1. Gourgoulianis KI, Chatziparasidis G, Chatziefthimiou A, Molyvdas PA. Magnesium as a relaxing factor of airway smooth muscles. J Aerosol Med 2001; 14:301.

2. Ni H, Aye SZ, Naing C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2022; 5:CD013506.

3. Kew KM, Kirtchuk L, Michell CI. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev 2014; :CD010909.