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The role of nebulized magnesium sulfate in addition to standardized therapy in the treatment of acute asthma exacerbations in adults.

机译：除标准疗法外，雾化的硫酸镁在成人急性哮喘加重中的作用。

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摘要

Introduction. Despite the multitude of the available treatment options, the incidence and mortality from asthma continue to increase. Approximately 30% of patients do not adequately respond to beta2-agonists in the emergency department and may require hospital admission. In search for additional treatment options, there has been an increased interest in the bronchodilatory effects of intravenous and nebulized magnesium sulfate (MgSO4).;Objective. To compare the efficacy and safety of adding nebulized MgSO4 to standardized therapy with albuterol over that of albuterol alone in patients with mild to moderate acute asthma exacerbations.;Methods. In this double-blind, placebo-controlled trial, adult patients undergoing an acute asthma attack were randomized to receive either nebulized MgSO4 (384 mg in 6 mL) or an equal volume of placebo (normal saline) after each dose of preservative-free nebulized albuterol (2.5 mg/3mL) every 20 minutes for the first hour of the study. Spirometry and monitoring of vital signs (heart rate, respiratory rate, blood pressure), and pulse oximetry were performed at baseline and every 20 minutes for 2 hours. Serum magnesium levels were drawn at baseline, after the last study drug dose, and at the completion of the study. The percent-predicted forced expiratory volume in the first second (FEV1) improvement was chosen as a primary efficacy endpoint. Secondary efficacy endpoints included improvement in percent-predicted peak expiratory flow rate (PEFR) and the rate of hospital discharge.;Results. Seventy-four patients were randomized to each of the study groups (37 patients in each group). There were no statistically significant differences in the baseline patient characteristics with the exception of age, height, and weight. Twenty patients were administered nebulized albuterol in an ambulance prior to the study entry. Nine patients in the MgSO4 group and five patients in the control group were missing monitoring data at ≤ 3 time points. There were no statistically or clinically significant differences between the two study groups in either primary or secondary efficacy endpoints. There were no significant differences in the vital signs or serum magnesium levels at any point during the study. The most common reported adverse events were dizziness, headache, somnolence, bitter taste of the study drug, and burning in the throat.;Conclusion. The combination of nebulized MgSO4 and albuterol provides no additional benefit over the standard therapy with albuterol alone in adult patients with mild-to-moderate asthma exacerbations.
机译：介绍。尽管有许多可用的治疗选择，但是哮喘的发病率和死亡率继续增加。大约30％的患者对急诊部门的β2受体激动剂没有足够的反应，可能需要住院。为寻求其他治疗选择，人们对静脉内和雾化的硫酸镁（MgSO4）的支气管扩张作用越来越感兴趣。比较轻度至中度急性哮喘急性加重患者中雾化硫酸镁加沙丁胺醇标准化治疗的疗效和沙丁胺醇单独治疗的有效性和安全性。在这项双盲，安慰剂对照试验中，接受急性哮喘发作的成年患者被随机分配，在每剂不含防腐剂的雾化剂后接受雾化的MgSO4（384 mg，6 mL）或等量的安慰剂（生理盐水）在研究的第一个小时，每20分钟一次沙丁胺醇（2.5 mg / 3mL）。在基线和每20分钟进行2小时的肺活量测定和生命体征监测（心率，呼吸频率，血压）和脉搏血氧饱和度。在基线，最后一次研究药物剂量后以及研究完成时抽取血清镁水平。预测的第一秒钟（FEV1）改善中的强制呼气量百分比是主要疗效终点。次要疗效终点包括百分比预测的最大呼气流速（PEFR）和医院出院率的改善。 74名患者被随机分配至每个研究组（每组37名患者）。除年龄，身高和体重外，基线患者特征无统计学差异。 20名患者在进入研究之前在救护车中接受雾化的沙丁胺醇治疗。在≤3个时间点，MgSO4组中的9例患者和对照组中的5例患者缺少监测数据。在主要或次要疗效指标方面，两个研究组之间在统计学或临床上均无统计学差异。在研究期间的任何时间点，生命体征或血清镁水平均无显着差异。报告的最常见不良事件为头晕，头痛，嗜睡，研究药物的苦味和咽喉灼痛。对于轻度至中度哮喘急性发作的成年患者，雾化的MgSO4和沙丁胺醇的组合比单独使用沙丁胺醇的标准疗法没有任何其他好处。

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  • 作者

    Bessmertny, Olga.;

  • 作者单位

    Long Island University, The Brooklyn Center.;

  • 授予单位 Long Island University, The Brooklyn Center.;
  • 学科 Pharmaceutical sciences.;Pharmacology.
  • 学位 Pharm.D.
  • 年度 1999
  • 页码 152 p.
  • 总页数 152
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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