MAGNESIUM



Table of Contents
image Magnesium and carbohydrate metabolism
image Disorders of magnesium metabolism
image Magnesium deficiency produces insulin resistance and increased thromboxane synthesis
image Magnesium and glucose homeostasis
image Magnesium content of erythrocytes in patients with vasospastic angina
image Variant angina due to deficiency of intracellular magnesium
image Magnesium and sudden death
image Magnesium deficiency produces spasms of coronary arteries: Relationship to etiology of sudden death ischemic heart disease
image Magnesium and potassium in diabetes and carbohydrate metabolism. Review of the present status and recent results.
image Hypocalcemia associated with estrogen therapy for metastatic adenocarcinoma of the prostate
image [Overview--suppression effect of essential trace elements on arteriosclerotic development and it's mechanism]
image Magnesium hormonal regulation and metabolic interrelations
image Magnesium deficiency: Possible role in osteoporosis associated with gluten-sensitive enteropathy
image Energy and nutrient intake in patients with CF
image Kidney stone clinic: Ten years of experience
image Plasma copper, zinc and magnesium levels in patients with premenstrual tension syndrome
image Oral magnesium successfully relieves premenstrual mood changes
image Magnesium and the premenstrual syndrome
image Magnesium concentration in brains from multiple sclerosis patients
image Zinc, copper and magnesium concentration in serum and CSF of patients with neurological disorders
image The susceptibility of the centrocecal scotoma to electrolytes, especially in multiple sclerosis
image Experimental and clinical studies on dysregulation of magnesium metabolism and the aetiopathogenesis of multiple sclerosis.
image Magnesium concentration in plasma and erythrocytes in MS
image Comparative findings on serum IMg2+ of normal and diseased human subjects with the NOVA and KONE ISE's for Mg2+
image Migraine--diagnosis, differential diagnosis and therapy]
image Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study.
image Electromyographical ischemic test and intracellular and extracellular magnesium concentration in migraine and tension-type headache patients.
image Magnesium supplementation and osteoporosis
image Calcium, phosphorus and magnesium intakes correlate with bone mineral content in postmenopausal women
image Magnesium in the physiopathology and treatment of renal calcium stones
image Urinary factors of kidney stone formation in patients with Crohn's disease
image Renal stone formation in patients with inflammatory bowel disease
image Magnesium metabolism in health and disease
image Prophylaxis of recurring urinary stones: hard or soft mineral water
image Urothelial injury to the rabbit bladder from various alkaline and acidic solutions used to dissolve kidney stones
image Cellular and humoral immunity in rats after gestational zinc or magnesium deficiency
image Prospective study of nutritional factors, blood pressure, and hypertension among US women.
image Association of macronutrients and energy intake with hypertension.
image Relations between magnesium, calcium, and plasma renin activity in black and white hypertensive patients
image Effect of renal perfusion pressure on excretion of calcium, magnesium, and phosphate in the rat.
image Concentration of free intracellular magnesium in the myocardium of spontaneously hypertensive rats treated chronically with calcium antagonist or angiotensin converting enzyme inhibitor
image Nonpharmacologic treatment of hypertension.
image Micronutrient effects on blood pressure regulation.
image Role of magnesium and calcium in alcohol-induced hypertension and strokes as probed by in vivo television microscopy, digital image microscopy, optical spectroscopy, 31P-NMR, spectroscopy and a unique magnesium ion-selective electrode.
image Consequences of magnesium deficiency on the enhancement of stress reactions; preventive and therapeutic implications (a review).
image Effect of dietary magnesium supplementation on intralymphocytic free calcium and magnesium in stroke-prone spontaneously hypertensive rats.
image Electrolytes and hypertension: results from recent studies.
image Calcium antagonists in pregnancy as an antihypertensive and tocolytic agent
image The pathogenesis of eclampsia: the 'magnesium ischaemia' hypothesis.
image Intracellular Mg2+, Ca2+, Na2+ and K+ in platelets and erythrocytes of essential hypertension patients: relation to blood pressure.
image A prospective study of nutritional factors and hypertension among US men
image Electrolytes in the epidemiology, pathophysiology, and treatment of hypertension.
image Minerals and blood pressure.
image The effect of Ca and Mg supplementation and the role of the opioidergic system on the development of DOCA-salt hypertension.
image Attenuated vasodilator responses to Mg2+ in young patients with borderline hypertension.
image Dietary modulators of blood pressure in hypertension
image Daily intake of macro and trace elements in the diet. 4. Sodium, potassium, calcium, and magnesium
image Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia.
image Relationship of magnesium intake and other dietary factors to blood pressure: the Honolulu heart study.
image Serum calcium, magnesium, copper and zinc and risk of cardiovascular death.
image Hypertension, diabetes mellitus, and insulin resistance: the role of intracellular magnesium
image [Guidelines on treatment of hypertension in the elderly, 1995--a tentative plan for comprehensive research projects on aging and health-- Members of the Research Group for "Guidelines on Treatment of Hypertension in the Elderly", Comprehensive Research Projects on Aging and Health, the Ministry of Health and Welfare of Japan]
image Micronutrient profiles in HIV-1-infected heterosexual adults
image Fish oil and other nutritional adjuvants for treatment of congestive heart failure
image The use of oral magnesium in mild-to-moderate congestive heart failure
image Magnesium supplementation in patients with congestive heart failure
image Magnesium: A critical appreciation
image Significance of magnesium in congestive heart failure
image The rationale of magnesium as alternative therapy for patients with acute myocardial infarction without thrombolytic therapy
image Mortality risk and patterns of practice in 4606 acute care patients with congestive heart failure: The relative importance of age, sex, and medical therapy
image The study of renal magnesium handling in chronic congestive heart failure
image Management of acute myocardial infarction in the elderly
image Supraventricular tachycardia after coronary artery bypass grafting surgery and fluid and electrolyte variables
image [Magnesium: current studies--critical evaluation--consequences]
image Magnesium deficiency-related changes in lipid peroxidation and collagen metabolism in vivo in rat heart.
image [Value of magnesium in acute myocardial infarct]
image Concentrations of magnesium, calcium, potassium, and sodium in human heart muscle after acute myocardial infarction.
image [MAGNESIUM in cardiology]
image MAGNESIUM therapy in acute myocardial infarction when patients are not candidates for thrombolytic therapy
image [Oral MAGNESIUM supplementation to patients receivingdiuretics -- normalization of MAGNESIUM, POTASSIUM and sodium, and POTASSIUM pumps in the skeletal muscles].
image Effects of intravenous MAGNESIUM sulfate on arrhythmias in patients with congestive heart failure.
image MAGNESIUM-POTASSIUM interactions in cardiac arrhythmia. Examples of ionic medicine.
image Clinical clues to MAGNESIUM deficiency.
image Muscle and serum magnesium in pulmonary intensive care unit patients.
image Unrecognized pandemic subclinical diabetes of the affluent nations: Causes, cost and prevention
image Vitamin and mineral deficiencies which may predispose to glucose intolerance of pregnancy
image Different effects of Mg2+ on endothelin-1- and 5-hydroxytryptamine- elicited responses in goat cerebrovascular bed
image Ethanol-induced contraction of cerebral arteries in diverse mammals and its mechanism of action
image Mgsup 2sup +-Casup 2sup + interaction in contractility of vascular smooth muscle: Mgsup 2sup + versus organic calcium channel blockers on myogenic tone and agonist-induced responsiveness of blood vessels
image The case for intravenous magnesium treatment of arterial disease in general practice: Review of 34 years of experience
image Acute hypermagnesemia after laxative use
image Antacids drugs: Multiple but too often unknown pharmacological properties
image [Magnesium: current concepts of its physiopathology, clinical aspects and therapy]
image Bronchial reactivity and dietary antioxidants
image Studies of the effects of inhaled magnesium on airway reactivity to histamine and adenosine monophosphate in asthmatic subjects
image Magnesium attenuates the neutrophil respiratory burst in adult asthmatic patients
image Physicochemical characterization of nedocromil bivalent metal salt hydrates. 1. Nedocromil magnesium
image Skeletal muscle magnesium and potassium in asthmatics treated with oral beta2-agonists
image Nutrient intake of patients with rheumatoid arthritis is deficient in pyridoxine, zinc, copper, and magnesium
image Magnesium in supraventricular and ventricular arrhythmias
image Ionic mechanisms of ischemia-related ventricular arrhythmias
image Trace elements in prognosis of myocardial infarction and sudden coronary death
image Magnesium flux during and after open heart operations in children.
image An expanded concept of "insurance" supplementation--broad-spectrum protection from cardiovascular disease.
image Intakes of vitamins and minerals by pregnant women with selected clinical symptoms.
image [Amyotrophic lateral sclerosis--causative role of trace elements]
image Aluminum Deposition in Central Nervous System of Patients with Amyotrophic Lateral Sclerosis From the Kii Peninsula of Japan
image [Deficiency of certain trace elements in children with hyperactivity]
image [Level of magnesium in blood serum in children from the province of Rzesz'ow]
image Frequently nebulized beta-agonists for asthma: effects on serum electrolytes.
image Effect of nebulized albuterol on serum potassium and cardiac rhythm in patients with asthma or chronic obstructive pulmonary disease.
image Calcium, phosphate, vitamin D, and the parathyroid
image Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome
image Rationales for micronutrient supplementation in diabetes.
image Comparison of the effects of magnesium hydroxide and a bulk laxative on lipids, carbohydrates, vitamins A and E, and minerals in geriatric hospital patients in the treatment of constipation.
image Small bowel obstruction caused by a medication bezoar: report of a case.
image Nonsustained polymorphous ventricular tachycardia during amiodarone therapy for atrial fibrillation complicating cardiomyopathy. Management with intravenous magnesium sulfate.
image The osmotic and intrinsic mechanisms of the pharmacological laxative action of oral high doses of magnesium sulphate. Importance of the release of digestive polypeptides and nitric oxide.
image Intravenous magnesium sulfate in acute severe asthma not responding to conventional therapy
image Effect of inhaled magnesium sulfate on sodium metabisulfite-induced Bronchoconstriction in asthma
image Magnesium sulfate therapy in certain emergency conditions
image Effect of intravenous magnesium sulphate on airway calibre and airway reactivity to histamine in asthmatic subjects
image Inhalation therapy with magnesium sulfate and salbutamol sulfate in bronchial asthma
image MgSO4 relaxes porcine airway smooth muscle by reducing Ca2+ entry
image Effect of intravenous magnesium sulfate on cardiac arrhythmias in critically III patients with low serum ionized magnesium
image The antiarrhythmic effects of taurine alone and in combination with magnesium sulfate on ischemia/reperfusion arrhythmia
image Magnesium taurate and fish oil for prevention of migraine.

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Nutrient intake of patients with rheumatoid arthritis is deficient in pyridoxine, zinc, copper, and magnesium

Journal of Rheumatology (Canada), 1996, 23/6 (990-994)

Objective. To determine nutrient intake of patients with active rheumatoid arthritis and compare it with the typical American diet (TAD) and the recommended dietary allowance (RDA). Methods. 41 patients with active RA recorded a detailed dietary history. Information collected was analyzed for nutrient intake of energy, fats, protein, carbohydrate, vitamins and minerals, which were then statistically compared with the TAD and the RDA. Results. Both men and women ingested significantly less energy from carbohydrates (women 47.4% (6.4) vs 55% RDA, p = 0.0001; men = 48.9% (7.4), p = 0.025) and more energy from fat (women = 36.8% (4.5) vs 30% RDA. p = 0.001 and men = 35.2% (5.9) p = 0.02). Women ingested significantly more saturated and mono-unsaturated fat than the RDA (p = 0.02 and p = 0.04 respectively) while men ingested significantly less polyunsaturated fat (PUFA)(p = 0.0001). Both groups took in less fiber (p = 0.0001). Deficient dietary intake of pyridoxine was observed vs the RDA for both sexes (men and women p = 0.0001). Deficient folate intake was seen vs the TAD for men (p = 0.02) with a deficient trend in women (p = 0.06). Zinc and magnesium intake was deficient vs the RDA in both sexes (p values less than or equal to 0.001) and copper was deficient vs the TAD in both sexes (p = 0.004 women and p = 0.02 men). Conclusion. Patients with RA ingest too much total fat and too little PUFA and fiber. Their diets are deficient in pyridoxine, zinc and magnesium vs the RDA and copper and folate vs the TAD. These observations, also documented in previous studies, suggest that routine dietary supplementation with multivitamins and trace elements is appropriate in this population.



Magnesium in supraventricular and ventricular arrhythmias

Zeitschrift fur Kardiologie (Germany), 1996, 85/SUPPL. 6 (135-145)

The use of magnesium as an antiarrhythmic agent in ventricular and supraventricular arrhythmias is a matter of an increasing but still controversial discussion during recent years. With regard to the well established importance of magnesium in experimental studies for preserving electrical stability and function of myocardial cells and tissue, the use of magnesium for treating one or the other arrhythmia seems to be a valid concept. In addition, magnesium application represents a physiologic approach, and by this, is simple, cost-effective and safe for the patient. However, when one reviews the available data from controlled studies on the antiarrhythmic effects of magnesium, there are only a few types of diac arrhythmias, such as torsade de pointes, digitalis-induced ventricular arrhythmias and ventricular arrhythmias occurring in the presence of heart failure or during the perioperative state, in which the antiarrhythmic benefit of magnesium has been shown and/or established. Particularly in patients with one of these types of cardiac arrhythmias, however, it should be realized that preventing the patient from a magnesium deficit is the first, and the application of magnesium the second best strategy to keep the patient free from cardiac arrhythmias.



Ionic mechanisms of ischemia-related ventricular arrhythmias

Clinical Cardiology (USA), 1996, 19/4 (325-331)

The aim of this review is the utmost simplification of the cellular electrophysiologic background of ischemia-related arrhythmias. In the acute and subacute phase of myocardial infarction, arrhythmias can be caused by an abnormal impulse generation, abnormal automaticity or triggered activity caused by early or delayed afterdepolarizations (EAD and DAD), or by abnormalities of impulse conduction (i.e., reentry). This paper addresses therapeutic intervention aimed at preventing the depolarization of 'pathologic' slow fibers, counteracting the inward calcium (Ca) influx that takes place through the L-type channels (Ca antagonists), or hyperpolarizing the diastolic membrane action potential increasing potassium (K) efflux (K- channel openers) in arrhythmias generated by an abnormal automaticity (ectopic tachycardias or accelerated idioventricular rhythms). If the cause of enhanced impulse generation is related to triggered activity, and since both EAD and DAD are dependent on calcium currents that can appear during a delayed repolarization, the therapeutic options are to shorten the repolarization phase through K-channel openers or Ca antagonists, or to suppress the inward currents directly responsible for the afterdepolarization with Ca blockers. Magnesium seems to represent a reasonable choice, as it is able to shorten the action potential duration and to function as a Ca antagonist. Abnormalities of impulse conduction (reentry) account for the remainder of arryhythmias that occur in the acute and subacute phase of ischemia and for most dysrhythmias that develop during the chronic phase. Reentrant circuits due to ischemia are usually Na channel-dependent. During choice will depend on the length of the excitable gap: in case of a short gap (ventricular fibrillation, polymorphic ventricular tachycardia, etc.), the refractory period has been identified as the most vulnerable parameter, and therefore a correct therapeutic approach will be based on drugs able to prolong the effective refractory period (K-channel blockers, such as class III antiarrhythmic drugs); on the other hand, for those arrhythmias characterized by a long excitable gap (most of the monomorphic ventricular tachycardias), the most appropriate therapeutic intervention consists of depressing ventricular excitability and conduction by use of sodium-channel blockers such as mexiletine and lidocaine. Compared with other class I antiarrhythmic agents, these drugs minimally affect refractoriness and exhibit a use-dependent effect and a voltage dependent action (i.e., more pronounced on the ischemic tissue because of its partial depolarization).



Trace elements in prognosis of myocardial infarction and sudden coronary death

Journal of Trace Elements in Experimental Medicine (USA), 1996, 9/2 (57-62)

Ca, Cu, Mg, Mn, and Zn concentrates were measured in plasma, RBC, and hair of 350 men aged 40-59 years with myocardial infarction (MI) and/or who died from sudden cardiac death (SCD), as compared with normal controls. Analyses were done by flame atomic absorption spectrophotometry. Cu in plasma of MI patients was significantly higher than the controls'. Plasma Mn was significantly lower in SCD than in MI subjects. No other consistent and significant changes were observed. Past and present evidence indicates that high plasma Cu levels may be associated with heart failure and rhythm disorders. The low plasma Mn levels may be an indicator of decreased parasympathetic tonus thus favouring myocardial desynchronization and A-V block. Cu inhibits phosphodiesterase activity and Mn inhibits andenylate cyclase activity thus exerting an influence on the contractility of cardiomyocites and of smooth muscle cells in coronary arteries. Cu and Mn analyses may thus have a prognostic significance for MI and SCD.



Magnesium flux during and after open heart operations in children.

Ann Thorac Surg (UNITED STATES) Apr 1995, 59 (4) p921-7

Hypomagnesemia and depletion of the body's magnesium stores is known to be associated with an increased incidence of both cardiac arrhythmias and neurological irritability. In a two-part prospective study we have evaluated whether magnesium deficiency is a significant occurrence in children treated in the intensive care unit after open heart operations, and subsequently have sought to identify how intraoperative metabolic changes were related to the resultant findings. In 41 children studied after operation the plasma magnesium concentration showed a significant decrease from 0.92 mmol/L (10th to 90th centile, 0.71 to 1.15 mmol/L) immediately after operation to 0.77 mmol/L (0.65 to 0.91 mmol/L) on the following morning. The subsequent change in grouped values was not significant but 14 (34.2%) and 7 (17.1%) possessed values of less than 0.7 mmol/L and 0.6 mmol/L, respectively. The occurrence of cardiac arrhythmias was not statistically related to the occurrence of hypomagnesemia. In 21 children perioperative changes in extracellular and tissue magnesium, potassium, and calcium content were measured. It was found that hemodilution with a prime low in magnesium caused a reduction from a median of 0.81 mmol/L to 0.61 mmol/L (p < 0.01). Plasma potassium level, however, was elevated from 3.7 mmol/L to 4.15 mmol/L (p < 0.05) and the ionized calcium content from 1.17 mmol/L (1.07 to 1.25 mmol/L) to 1.49 mmol/L (1.25 to 2.56 mmol/L) (p = 0.0009). The myocardial content of magnesium did not change significantly but skeletal muscle content was depleted from 6.75 mumol/g (2.85 to 8.35 mumol/g) to 5.65 mumol/g (2.45 to 7.2 mumol/g) (p < 0.01)



An expanded concept of "insurance" supplementation--broad-spectrum protection from cardiovascular disease.

Med Hypotheses (ENGLAND) Oct 1981, 7 (10) p1287-1302

The preventive merits of "nutritional insurance" supplementation can be considerably broadened if meaningful doses of nutrients such as mitochondrial "metavitamins" (coenzyme Q, lipoic acid, carnitine), lipotropes, and key essential fatty acids, are included in insurance supplements. From the standpoint of cardiovascular protection, these nutrients, as well as magnesium, selenium, and GTF-chromium, appear to have particular value. Sophisticated insurance supplementation would likely have a favorable impact on many parameters which govern cardiovascular risk--serum lipid profiles, blood pressure, platelet stability, glucose tolerance, bioenergetics, action potential regulation--and as a life-long preventive health strategy might confer substantial benefit. (111 Refs.)



Intakes of vitamins and minerals by pregnant women with selected clinical symptoms.

J Am Diet Assoc (UNITED STATES) May 1981, 78 (5) p477-82

Toxemia in pregnancy is characterized by a combination of at least two of the following clinical symptoms: hypertension, edema, and proteinuria. In this study the dietary intakes of young pregnant women attending a Maternal and Infant Care Program at Tuskegee Institute were evaluated for selected vitamins and minerals. Women with toxemia were identified, and women without toxemia served as controls. The toxemia group generally consumed lesser amounts of vitamins and minerals than the controls. However, both groups were deficient (less than two-thirds RDA) in calcium, magnesium, vitamin B6, vitamin B12, and thiamin. Milk, meat, and grains supplied an appreciable proportion of each vitamin except vitamin A, which was found primarily in the two vegetable groups. Meat and grains contained the greatest quantities of minerals, but milk provided a relatively good proportion of potassium, calcium, magnesium, and phosphorus. Anemia was not related to the incidence of toxemia. Women exhibiting anemia consumed smaller amounts of vitamins studied than did women without anemia.



[Amyotrophic lateral sclerosis--causative role of trace elements]

Nippon Rinsho (JAPAN) Jan 1996, 54 (1) p123-8

Although numerous hypotheses have been proposed for the cause of amyotrophic lateral sclerosis (ALS), conclusive decision still remains vague. Recent epidemiological investigation disclosed an aggregation of ALS cases in the Western Pacific, including the Kii Peninsula of Japan, the island of Guam in Marianas and West New Guinea. Extensive environmental studies in these foci indicated an important role of trace elements in ALS etiology. It is postulated that chronic environment deficiencies of calcium and magnesium may provoke secondary hyperparathyroidism, resulting in increased intestinal absorption of toxic metals under the presence of excess levels of divalent or trivalent cations and lead to the mobilization of calcium and metals from the bone and deposition of these elements in nervous tissue. This hypothesis, called metal-induced calcifying degeneration of CNS, has been supported by experimental studies using several animal species. (15 Refs.)



Aluminum Deposition in Central Nervous System of Patients with Amyotrophic Lateral Sclerosis From the Kii Peninsula of Japan

Neurotoxicology, 1991; 615-620

Low calcium/magnesium intake with excess amounts of aluminum and manganese are associated with the incidence of amyotrophic lateral sclerosis (ALS) in the Western Pacific. Two Japanese case reports of ALS showed markedly elevated concentrations of aluminum in the CNS. In 6 other cases of ALS and 5 neurologically normal controls it was found that aluminum concentrations in the precentral gyrus, internal capsule, crus cerebri and spinal cord were significantly higher in 2 ALS patients compared to the controls. Mean aluminum concentrations in 26 different central nervous system regions in the 2 patients were higher than controls and 4 of the ALS cases. Magnesium concentrations in 26 central nervous system regions were markedly reduced in the ALS cases. Calcium/magnesium ratios were significantly increased in ALS patients. The authors conclude that the high incidence of ALS in the Western Pacific may be due to calcium/magnesium dismetabolism resulting in excess deposition of aluminum.



[Deficiency of certain trace elements in children with hyperactivity]

Psychiatr Pol (POLAND) May-Jun 1994, 28 (3) p345-53

The magnesium, zinc, copper, iron and calcium level of plasma, erythrocytes, urine and hair in 50 children aged from 4 to 13 years with hyperactivity, were examined by AAS. The average concentration of all trace elements was lower compared with the control group-healthy children from Szczecin. The highest deficit was noted in hair. Our results show that it is necessary to supplement trace elements in children with hyperactivity.



[Level of magnesium in blood serum in children from the province of Rzesz'ow]

Wiad Lek (POLAND) Feb 1993, 46 (3-4) p120-2

In 142 girls and 107 boys aged 5-15 years serum magnesium level was determined by the colorimetric method. Decreased values were found in 24 children including 7 boys and 17 girls. In 21 of them neurotic reactions or concentration disturbances were observed.



Frequently nebulized beta-agonists for asthma: effects on serum electrolytes.

Ann Emerg Med (UNITED STATES) Nov 1992, 21 (11) p1337-42

STUDY OBJECTIVE: To determine the magnitude of the changes in serum potassium, magnesium, and phosphate during the treatment of acute bronchospasm with repeated doses of beta-adrenergic agonists. DESIGN: Prospective study of a convenience sample of asthmatic patients. SETTING: University teaching hospital emergency department. TYPE OF PARTICIPANTS: Twenty-three patients met the inclusion criteria of age of more than 16 years; a history of asthma or chronic obstructive pulmonary disease; and an acute exacerbation. INTERVENTIONS: Baseline peak expiratory flow rate and serum potassium, magnesium, and phosphate levels were measured. Nebulized albuterol (2.5 mg) was administered every 30 minutes until the patient was discharged from the ED. Before each albuterol treatment, repeat serum levels of potassium, magnesium, and phosphate were determined. MEASUREMENTS AND MAIN RESULTS: Baseline peak expiratory flow rate averaged 188 +/- 119 L/min. Serum potassium levels decreased significantly (P = .0001 by repeated-measures analysis of variance) from 4.10 +/- 0.468 (baseline) to 3.55 +/- 0.580 mmol/L (90 minutes) and 3.45 +/- 0.683 mmol/L (180 minutes). Potassium decreased to less than 3.0 mmol/L in 22% of patients at some point during the study. Magnesium decreased from 1.64 +/- 0.133 mmol/L (baseline) to 1.48 +/- 0.184 mmol/L (90 minutes) and 1.40 +/- 0.219 mmol/L (180 minutes) (P = .0001). Phosphate levels also decreased, from 3.74 +/- 1.029 (baseline) to 2.84 +/- 0.957 mmol/L (90 minutes) and 2.55 +/- 0.715 mmol/L (180 minutes) (P = .0001). CONCLUSION: Aggressive administration of nebulized albuterol during the emergency treatment of acute bronchospasm is associated with statistically significant decreases in serum potassium, magnesium, and phosphate. The mechanism and clinical significance of these findings are unknown and warrant further study.



Effect of nebulized albuterol on serum potassium and cardiac rhythm in patients with asthma or chronic obstructive pulmonary disease.

Pharmacotherapy (UNITED STATES) Nov-Dec 1994, 14 (6) p729-33

STUDY OBJECTIVE. To evaluate the metabolic and cardiopulmonary effects of nebulized albuterol in patients suffering moderate to severe exacerbations of asthma or chronic obstructive pulmonary disease. DESIGN. Open-label, prospective study. SETTING. The emergency department of a university medical center. PATIENTS. Ten patients with moderate to severe exacerbation of asthma. INTERVENTIONS. Each patient received nebulized albuterol 2.5 mg for approximately 10 minutes. MEASUREMENTS AND MAIN RESULTS. Serum potassium, heart rate and rhythm, blood pressure, and pulmonary function were measured before treatment and every 15 minutes for 2 hours after treatment. Serum potassium concentrations decreased significantly (p < 0.05) within 75 minutes after initiation of treatment, from a baseline value of 4.5 +/- 0.6 mEq/L (range 3.5-5.5 mEq/L) to 3.7 +/- 0.5 mEq/L (range 2.8-4.4 mEq/L) at the end of the collection period (120 minutes). Forced expiratory volume in 1 second significantly increased over time in patients with asthma (p < 0.05). No statistically significant changes in blood pressure, heart rate, or corrected QT intervals occurred. Pre-emergency department use of a beta 2-agonist by metered-dose inhaler was not associated with a decreased serum potassium on admission. CONCLUSIONS. Nebulized beta 2-agonists are generally efficacious and safe in patients with acute bronchospasms. However, close monitoring of serum electrolytes, heart rate, and rhythm in patients at risk (elderly, those with pre-existing cardiac disease) is advised before these individuals receive repeat doses by continuous aerosol administration.



Calcium, phosphate, vitamin D, and the parathyroid

Pediatric Nephrology (Germany), 1996, 10/3 (364-367)

The main factors which regulate parathyroid hormone (PTH) production are calcium, phosphate, vitamin D, and estrogens. Hypocalcemia leads to increased PTH secretion in seconds and minutes, gene expression in hours, and parathyroid (PT) cell number in weeks and months. Hypercalcemia leads to a decrease in PTH secretion by its action on the PT cell calcium receptor and no decrease in PTH mRNA levels. There is now convincing evidence that phosphate regulates the PT, independent of its effect on serum calcium and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). In vivo in rats hypophosphatemia markedly decreases PTH mRNA and serum intact PTH levels, independent of its effect on serum calcium and 1,25(OH)2D3. Clinical studies also indicate that phosphate regulates the PT independent of its effect on calcium and 1,25(OH)2D3; 1,25(OH)2D3 itself has a marked effect on the PT, where it decreases PTH gene transcription by a direct action on the PT. The application of basic science findings of how calcium, phosphate, and 1,25(OH)2D3 regulate the PT has led to an efficient and safe prescription for the management of the secondary hyperparathyroidism of chronic renal failure, which is the maintenance of a normal serum calcium and phosphate and the careful use of 1,25(OH)2D3.



Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome

J. REPROD. MED. (USA), 1987, 32/6 (435-441)

Many different treatments have been suggested for the premenstrual syndrome (PMS), including such nutritional supplements as vitamins, minerals and essential fatty acids. There is little agreement about the causes or treatments of the syndrome. The effect of a nutritional supplement, at high and low dosage, on premenstrual symptoms was assessed in a double-blind, placebo-controlled study. Also, the nutritional state of 11 women with PMS was evaluated. There was laboratory evidence of significant deficiencies in vitamin Bsub 6 and magnesium; other deficiencies occurred frequently, also. The multivitamin/multi-mineral supplement was shown to correct some of these deficiencies and, at the appropriate dosage, to improve the symptoms of premenstrual tension.



Rationales for micronutrient supplementation in diabetes.

Med Hypotheses (ENGLAND) Feb 1984, 13 (2) p139-51

Available evidence--some well-documented, some only preliminary--suggests that properly-designed nutritional insurance supplementation may have particular value in diabetes. Comprehensive micronutrient supplementation providing ample doses of antioxidants, yeast-chromium, magnesium, zinc, pyridoxine, gamma-linolenic acid, and carnitine, may aid glucose tolerance, stimulate immune defenses, and promote wound healing, while reducing the risk and severity of some of the secondary complications of diabetes. (125 Refs.)



Comparison of the effects of magnesium hydroxide and a bulk laxative on lipids, carbohydrates, vitamins A and E, and minerals in geriatric hospital patients in the treatment of constipation.

J Int Med Res (ENGLAND) Sep-Oct 1989, 17 (5) p442-54

In a crossover study the effects of magnesium hydroxide on serum lipids, carbohydrates, vitamins A and E, uric acid and whole blood minerals were compared with those of a bulk laxative containing plantago rind and sorbitol in 64 constipated, elderly long-stay patients, 55 of whom were receiving diuretics. Hypomagnesaemia occurred in 11 (17%) patients after bulk laxative and in two (2%) patients after magnesium hydroxide treatment. There was a slight reduction in low values of high-density lipoprotein cholesterol and high values of triglycerides after magnesium hydroxide treatment. There were no significant differences in plasma lipids, whole blood minerals or vitamins A and E using either laxative. Negative correlations were found between the increase in serum concentrations of magnesium and glycosylated haemoglobin A1 (P less than 0.02) and the serum level of uric acid (P less than 0.01). These results suggest that the long-term effects of magnesium hydroxide and bulk laxative on the absorption of nutrients may not be significantly different. Magnesium hydroxide, however, may have beneficial effects on lipid disorders, impaired glucose tolerance and hyperuricaemia in magnesium deficiency due to diuretics and thus may be a favourable laxative for use in bedridden geriatric patients receiving diuretics.



Small bowel obstruction caused by a medication bezoar: report of a case.

Surg Today (JAPAN) 1996, 26 (1) p68-70

We report herein the rare case of a 26-year-old woman who developed a small-bowel obstruction caused by a medication "bezoar" or enterolith, following the long-term ingestion of magnesium oxide cathartics for constipation. Medication bezoars resulting from laxatives or cathartics have rarely been reported and we were only able to find two other such cases in the literature.



Nonsustained polymorphous ventricular tachycardia during amiodarone therapy for atrial fibrillation complicating cardiomyopathy. Management with intravenous magnesium sulfate.

Chest (UNITED STATES) May 1997, 111 (5) p1454-7

A case is presented in which amiodarone was administered to suppress paroxysmal atrial fibrillation in a patient with an idiopathic cardiomyopathy. Eleven days after initiation of therapy with amiodarone, the patient experienced syncope and was noted to have recurrent episodes of polymorphous ventricular tachycardia. The patient was hospitalized and treated with a bolus as well as continuous infusion of intravenous magnesium sulfate. When the infusion was transiently discontinued, recurrences of polymorphous ventricular tachycardia were noted. The probable proarrhythmic action of amiodarone, although rare, is reviewed along with a discussion of the novel use of intravenous magnesium sulfate therapy. (6 Refs.)



The osmotic and intrinsic mechanisms of the pharmacological laxative action of oral high doses of magnesium sulphate. Importance of the release of digestive polypeptides and nitric oxide.

Magnes Res (ENGLAND) Jun 1996, 9 (2) p133-8

A common use for high doses of oral magnesium salts is to produce a laxative effect to treat constipation. In the intestinal lumen the poorly absorbable magnesium ions (and other ions such as sulphate) exert an osmotic effect and cause water to be retained in the intestinal lumen. This increases the fluidity of the intraluminal contents and results in a laxative action. Although the laxative action of magnesium is thought to be due to a local effect in the intestinal tract, it is also possible that released hormones such as cholecystokinin or activation of constitutive nitric oxide synthase might contribute to this pharmacological effect. Under normal circumstances the pharmacological administration of high doses of oral magnesium salts is safe and some salts--such as magnesium hydroxide--also have an antacid effect to neutralize stomach acid. However, high doses of magnesium or prolonged use may allow sufficient absorption into the systemic circulation to cause renal or other organ toxicity. (35



Intravenous magnesium sulfate in acute severe asthma not responding to conventional therapy

Indian Pediatrics (India), 1997, 34/5 (389-397)

Objective: To evaluate the effectiveness of early administration of intravenous magnesium sulfate (IV MgSo4) in children with acute severe asthma not responding to conventional therapy. Design: Randomized double-blind, placebo-controlled trial. Setting: Pediatric emergency service of a large teaching hospital. Subjects: 47 children aged between 1-12 years with acute severe asthma showing inadequate or poor response to 3 doses of nebulized salbutamol given at an interval of 20 min each. Intervention: The MgSO4 group received 0.2 mg/kg of 50% MgSO4 as intravenous (IV) infusion over 35 minutes and the placebo group received normal saline infusion in the same dose and at the same rate. MgSO4 solution and normal saline were coded and dispended in identical containers. Decoding was done at the completion of the study. All the patients received oxygen, nebulized salbutamol, IV aminophylline and corticosteroids. Results: MgSO4 group showed early and significant improvement as compared to placebo group in PEFR and SaO2 at 30 min and 1, 2, 3 and 7 hours after stopping the infusion (p ranging from <0.05 to <0.01). The clinical asthma score also showed significant improvement in the MgSO4 group 1, 2, 3 and 11 hours after stopping the infusion (p < 0.01). Conclusion: Addition of MgSO4 to conventional therapy helps in achieving earlier improvement in clinical signs and symptoms of asthma and PEFR in patients not responding to conventional therapy alone.



Effect of inhaled magnesium sulfate on sodium metabisulfite-induced Bronchoconstriction in asthma

Chest (USA), 1997, 111/4 (858-861)

Background: Inhaled magnesium (Mg) seemed to have a mild protective (nonbronchodilator) effect against histamine and methacholine. Inhaled sodium metabisulfite (MBS) causes bronchoconstriction in asthma through indirect mechanisms that involve sensory, nerve stimulation, and it is extensively used to study airway hyperresponsiveness. We designed this double-blind, randomized, crossover, and placebo-controlled study to test the effect of nebulized Mg sulfate against indirect challenge with MBS. Methods: Ten asthmatic subjects (three male) aged 38.8 (3.29, SEM) years came on three occasions to perform MBS challenges 5 min after inhalation of either normal saline solution as placebo or Mg sulfate (4 mL; 286 mOsm). Doubling increasing concentrations of MBS were administered by continuous nebulization at tidal breathing during 1 min starting at 0.3 to 80 mg/mL until a >20% fall in FEV1 (PC20) from post saline solution baseline value was achieved. PC20 values were logarithmically transformed before analysis. Results: The mean baseline FEV1 at control day was 2.52 (0.14) L and 88.46 (4.28) percentage predicted, while the geometric mean MBS PC20 was 1.95 (1.38, geometric SEM) mg/mL. After placebo, the geometric mean PC20 was 2.26 (1.26) mg/mL. Inhaled Mg increased significantly the PC20 to 5.06 (1.52) mg/mL; p<0.05. Mg diminished the bronchoconstrictor response to MBS by 1.3 doubling doses (p=0.08). Conclusions: Inhaled Mg attenuates MBS-induced bronchoconstriction in these asthmatic subjects. This new feature of Mg, even modest in magnitude, emphasizes the necessity of studying the potential role of this cation in modulating airway response.



Magnesium sulfate therapy in certain emergency conditions

American Journal of Emergency Medicine (USA), 1997, 15/2 (182-187)

Intravenous magnesium has been suggested as a treatment for certain emergency conditions for more than 60 years. It is currently proposed to be beneficial in treating asthma, preeclampsia, eclampsia, myocardial infarction, and cardiac arrhythmias. The use and efficacy of the drug, however, are controversial. This article discusses the current state of magnesium sulfate research and therapy.



Effect of intravenous magnesium sulphate on airway calibre and airway reactivity to histamine in asthmatic subjects

British Journal of Clinical Pharmacology (United Kingdom), 1996, 42/5

(629-631)

In a randomized, double-blind, placebo controlled cross-over study we have investigated the effect of intravenous magnesium on airway calibre and airway reactivity to histamine in 20 subjects with mild to moderate asthma. After baseline measurements of forced expiratory volume in one second (FEV1), subjects received 100 ml normal saline with or without 2 g of magnesium sulphate by infusion over 20 min. Measurements of FEV1 were repeated at 5 min intervals throughout the infusion, and the provocative dose of histamine required to drop the FEV1 by 20% from baseline (PD20FEV1) was determined at 20 min. The area under the curve (AUC) in litre minutes for change from baseline in FEV1 between 0 and 20 min was significantly higher on the magnesium study day (mean difference in AUC (95% CI) 1.71 (0.02-3.4), P = 0.049). The increase in FEV1 from baseline with magnesium relative to saline was maximal at 20 min (mean difference (95% CI) 0.13 (0.02-0.23) l, P = 0.01). Log PD20 FEV1 to histamine was not significantly different after magnesium and saline (mean difference in log PD20FEV1 (95% CI) 0.04 (-0.19 to 0.27), P = 0.7). We conclude that intravenous magnesium is a weak bronchodilator but does not alter airway reactivity at this dose in stable asthmatic subjects.



Inhalation therapy with magnesium sulfate and salbutamol sulfate in bronchial asthma

Turkish Journal of Pediatrics (Turkey), 1996, 38/2 (169-175)

Inhalation therapy with magnesium sulfate and salbutamol sulfate was applied to two groups, each consisting of 20 patients with acute asthma. The effects of inhaled magnesium sulfate and salbutamol sulfate were compared. The evaluation of patients was done using respiratory score, peak expiratory flow rate with a Wright peak flow meter, respiration rate, heart rate and blood pressure. Although magnesium sulfate's bronchedilating effect continued for approximately one hour, treatment of acute asthma using salbutamol sulfate inhalation was found to be more successful and its effect continued for six hours.



MgSO4 relaxes porcine airway smooth muscle by reducing Ca2+ entry

American Journal of Physiology - Lung Cellular and Molecular Physiology (USA), 1996, 270/3 14-3 (L469-L474)

Magnesium sulfate (MgSO4) is used clinically, but its mechanism of action is unknown. To determine whether MgSO4 relaxes airway smooth muscle and to investigate the pathways involved, we compared effects of MgSO4 in porcine tracheal and bronchial muscles contracted with either carbachol or KCl and measured the effects of MgSO4 on the concentration of intracellular free calcium ((Ca2+)(i)). Lungs were dissected after anesthesia and exsanguination. Tracheal strips and bronchial rings were suspended in tissue baths for measurement of isometric tension in the presence of different concentrations of MgSO4. In separate experiments, tracheal smooth muscle tension and (Ca2+)(i) were measured simultaneously, using the fluorescent dye fura 2. MgSO4 (1.2, 2.2, 9.2 mM) produced a concentration-dependent rightward shift of contraction dose-response curves to KCl but not to carbachol. MgSO4 relaxed trachealis muscles precontracted with KCl or carbachol and simultaneously decreased (Ca2+)(i). These findings indicate that MgSO4 directly relaxes airway smooth muscle and that the mechanism involves a decrease in (Ca2+)(i). Because initiation and maintenance of contraction during KCl stimulation and maintenance of contraction during carbachol stimulation require Ca2+ entry through voltage-dependent calcium channels, MgSO4-induced relaxation may involve a decrease in Ca2+ entry via these channels.



Effect of intravenous magnesium sulfate on cardiac arrhythmias in critically III patients with low serum ionized magnesium

Japanese Circulation Journal (Japan), 1996, 60/11 (871-875)

Magnesium affects cardiac function, although until the recent development of a new ion selective electrode no method existed for measuring the physiologically active form of magnesium, free ions (iMg2+), in the blood. We investigated the antiarrhythmic effect of magnesium sulfate administered to critically ill patients with cardiac arrhythmias and reduced iMg2+ as determined using the ion-selective electrode. Eight patients with a low iMg2+ level (less than 0.40 mmol/L) were given intravenous magnesium sulfate (group L). Magnesium sulfate was also administered to patients with a normal iMg2+ level (more than 0.40 mmol/L) but who did not respond to conventional antiarrhythmic drugs (group N). Intravenous magnesium sulfate significantly increased the iMg2+ level in patients in group L from 0.35plus or minus0.06 mmol/L (mean plus or minus SD) to 0.54 plus or minus 0.09 mmol/L (p<0.01), and had an antiarrhythmic effect in 7 of the 8 patients (88%). However, in group N patients, intravenous magnesium sulfate had an antiarrhythmic effect in only 1 of the 6 patients (17%) (p<0.05 vs group L). These results suggest that intravenous magnesium sulfate may be effective in the acute management of cardiac arrhythmias in patients with a low serum iMg2+ level.



The antiarrhythmic effects of taurine alone and in combination with magnesium sulfate on ischemia/reperfusion arrhythmia

Chinese Pharmacological Bulletin (China), 1994, 10/5 (358-362)

The effect of tauring (Taur) alone and in combination with magnesium sulfate (MgSO4) on ischemia/reperfusion arrhythmia was investigated. The arrhythmia as produced by coronary artery occlusion for 10 min followed by reperfusion. In addition, the present study also observed the effect of MgSO4 alone and in combination with Taur on hemodynamics. The results showed that Taur (50 mg . kg-1) and MgSO4 (25 mg . kg-1) had partly antiarrhythmic effect. Taur (100, 150mg. kg-1) MgSO4 (50, 100mg. kg-1) had significantly antiarrhythmic effect. Taur (50 mg. kg-1) combined with MgSO4 (25 mg. kg-1) shortened the duration of ventricular tachycardia (VT) more than that either drug did alone. The hypotensive effect of MgSO4 (25 mg. kg-1) was not increased by coadministration of Taur, but the myocardial oxygen consumption was reduced. These findings indicate that Taur in combination with MgSO4 is more effect on reperfusion arrhythmia, and that the mechanism of antiarrhythmic effect of Taur and MgSO4 may be involved in the effect of defence on myocardium.



Magnesium taurate and fish oil for prevention of migraine.

Med Hypotheses (ENGLAND) Dec 1996, 47 (6) p461-6

Although the pathogenesis of migraine is still poorly understood, various clinical investigations, as well as consideration of the characteristic activities of the wide range of drugs known to reduce migraine incidence, suggest that such phenomena as neuronal hyperexcitation, cortical spreading depression, vasospasm, platelet activation and sympathetic hyperactivity often play a part in this syndrome. Increased tissue levels of taurine, as well as increased extracellular magnesium, could be expected to dampen neuronal hyperexcitation, counteract vasospasm, increase tolerance to focal hypoxia and stabilize platelets; taurine may also lessen sympathetic outflow. Thus it is reasonable to speculate that supplemental magnesium taurate will have preventive value in the treatment of migraine. Fish oil, owing to its platelet-stabilizing and antivasospastic actions, may also be useful in this regard, as suggested by a few clinical reports. Although many drugs have value for migraine prophylaxis, the two nutritional measures suggested here may have particular merit owing to the versatility of their actions, their safety and lack of side-effects and their long-term favorable impact on vascular health. (94 Refs.)

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