Acute digitalis poisoning: The role of intravenous magnesium sulfate

Magnesium Sulfate Potentiates Effect of Digifab on Marinobufagenin-Induced Na/K-ATPase Inhibition

“…Accordingly, in vitro, MBG potently inhibited Na/K-ATPase in erythrocytes from control subjects and Mg 2+ desensitized Na/K-ATPase to MBG. These findings agree with previous clinical data demonstrating that MgSO 4 is capable of offsetting the deleterious cardiac effects of digitalis overdose 12 and that Mg 2+ ions are capable of changing Na/K-ATPase conformation. 10 Our observations suggest that MgSO 4 is capable of increasing the efficacy of DigiFab-mediated immunoneutralization of MBG-induced Na/K-ATPase inhibition in pathological states in which levels of CTSs are elevated.…”

“…10,11 Notably, in vivo Mg ions antagonize digitalis-induced toxicity, which is mediated by Na/K-ATPase inhibition. 12 Mg deficiency, on the contrary, sensitizes myocardium to the proarrhythmic action of digitalis. 13 Because of the above evidence and because Mg sulfate (MgSO 4 ) exerts beneficial effects in PE, 1 we hypothesized that MgSO 4 would potentiate the effect of DigiFab with respect to Na/K-ATPase restoration and reduction of blood pressure in PE.…”

Toad Intoxication in the Dog by Rhinella marina: The Clinical Syndrome and Current Treatment Recommendations

“…Parenteral magnesium may be beneficial, particularly in the management of ventricular arrhythmias, because hypomagnesemia potentiates the effects of cardiac glycosides. 54 Magnesium is required for normal functioning of the Na þ , K þ -ATPase pump, so it is vital for maintaining the normal resting membrane potential of excitable membranes. 55 Magnesium also modulates the binding of cardiac glycosides to the Na þ , K þ -ATPase pump, so its presence serves to antagonize the effects of cardiac glycosides on pump functioning.…”

“…55 Magnesium also modulates the binding of cardiac glycosides to the Na þ , K þ -ATPase pump, so its presence serves to antagonize the effects of cardiac glycosides on pump functioning. 54,56 Magnesium sulfate (0.15 to 0.3 mEq/kg IV over 10 min) can be used to correct hypomagnesemia. 43…”

Digitalis Glycosides

“…Magnesium sulfate was effectively used to treat digoxin-induced arrhythmias, even in patients with normal or slightly elevated serum magnesium concentrations [30][31][32] (Grade II-3 evidence). Magnesium potentiates the activity of Na + /K + -ATPase without altering digoxin binding.…”