Background: Short acting ß2-agonist is considered the main stay of therapy in acute asthma episodes, but it could not completely relieve the bronchospasm and reduce dyspnea. One of the other treatments is magnesium sulphate (MgSO4). Nebulized MgSO4 effect has been less evaluated in asthmatics. Aim of the Work: To compare the effects of nebulized MgSO4 in higher doses versus salbutamol nebulization in severe asthmatic attacks in adults. Patients and Methods: Two hundreds asthmatic patients with acute severe attacks were included in an interventional study. Following initial clinical evaluation and spirometric measurements; peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1%) measurements, patients were divided into two equal groups; group I: nebulized salbutamol and group II: nebulized MgSO4. Salbutamol group received salbutamol (2.5 ml) + isotonic saline (2.5 ml) while MgSO4 group received MgSO4 (500mg), 7.5 ml (2 mmol vial), through a jet nebulizer. The nebulization was given three times for the first two hours, 20 minutes apart, and then every hour for the remaining four hours. After that clinical reevaluation, PEF and FEV1% measurements were done. Results: The pre-nebulizer clinical parameters, PEF and FEV1 were nearly similar between groups I and II:
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