Limitations of the results from randomized clinical trials involving intravenous and nebulised magnesium sulphate in adults with severe acute asthma

Javor, Eugen; Grle, Sanja Popović

doi:10.1016/j.pupt.2019.01.005

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Magnesium sulfate (MgSO 4 ) is reported to have a powerful relaxation of airway smooth muscle, so it is often proposed to treat asthma ( Javor and Grle, 2019 ). Liu et al found that the incidence of FIC declined from 50.0% to 20.0% and 5.4% after the usage of 30 and 50 mg⋅kg −1 of MgSO 4 , respectively.…”

Section: Prevention and Treatment Of Fentanyl-induced Coughmentioning

confidence: 99%

Mechanism and Management of Fentanyl-Induced Cough

et al. 2020

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Fentanyl-induced cough (FIC) often occurs after intravenous bolus administration of fentanyl analogs during induction of general anesthesia and analgesia procedure. The cough is generally benign, but sometimes it causes undesirable side effects, including elevated intra-abdominal, intracranial or intraocular pressure. Therefore, understanding the related mechanisms and influencing factors are of great significance to prevent and treat the cough. This paper reviews the molecular mechanism, influencing factors and preventive administration of FIC, focusing on the efficacy and side effects of various drugs in inhibiting FIC to provide some medical reference for anesthesiologists.

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Section: Prevention and Treatment Of Fentanyl-induced Coughmentioning

confidence: 99%

Mechanism and Management of Fentanyl-Induced Cough

et al. 2020

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“…3 Therefore, the role of magnesium sulphate in obtunding fentanyl-induced cough was investigated in clinical trials based on its properties as a calcium antagonist and smooth muscle relaxant. 12,13 In this study, the incidence of fentanyl-induced cough in the control group was 11.4%, where the dose of fentanyl was 2 μg/kg delivered over 3 seconds. The incidence of fentanyl-induced cough differs according to the patient's age group, fentanyl dosage, and the speed of fentanyl administration.…”

Section: Discussionmentioning

confidence: 67%

Magnesium sulphate pretreatment obtunds fentanyl-induced cough during general anaesthesia induction

Maaya

Masdar

Mahdi

et al. 2022

MYJA

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Introduction: Fentanyl-induced cough is common during induction of general anaesthesia. This unpleasant cough may increase the intraocular, intracranial, and intraabdominal pressure. We hypothesised that 30 mg/kg of prophylactic intravenous magnesium sulphate is effective in obtunding 2 μg/kg fentanyl-induced cough.Methods: One hundred and forty patients scheduled for general anaesthesia, aged between 18 to 70 years old with American Society of Anesthesiologists physical status I were randomised into two groups. Group I and Group II patients received 30 mg/kg intravenous magnesium sulphate and normal saline, respectively. The solution studied was infused over 15 minutes followed by a fentanyl bolus 2 μg/kg delivered within 3 seconds. The incidence of cough and severity were documented. Mean arterial pressure and heart rate were recorded every 5 minutes during the infusion.Results: Eight patients (11.4%) had cough in Group II and one (1.4%) in Group I. Compared to Group II, the incidence and severity of cough were significantly lower in Group I (p = 0.003 and p = 0.037), respectively. There was no significant difference regarding the haemodynamic status between the two groups during the infusion of both solutions.Conclusion: During general anaesthesia induction, 30 mg/kg of intravenous magnesium sulphate effectively obtunded fentanyl-induced cough.

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“…The hospital medicines policy design is a complex process, and requires an understanding of evidence-based medicine (EBM) and its translation into value-based medicine (VBM). The clinical pharmacist fulfilled these requirements by its competencies, [10][11][12][13][14][15][16][17][18] and was included in the DTC as an active member and redesigned the public procurement for medicines. The clinical pharmacist's approach in hospital medicines policy included encouraging rational, generic, therapeutically equivalent and biosimilar medicines prescribing, in line with regulations from the authorities, EBM and VBM data.…”

Section: Methodsmentioning

confidence: 99%

The economic impact of a clinical pharmacist’s involvement in the hospital medicines policy in a rural area

Javor

Allouch

Galic³

et al. 2021

Int J Clin Pract

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Current trends in healthcare expenditures suggest an increase at alarmingly high rates. In Europe, the majority of the European Union (EU) Member States recorded a higher healthcare expenditure in 2016 compared with 2011. This trend was most pronounced in Estonia, where a 45.3% higher expenditure in 2016 was recorded, compared with 2011. 1 Considering the United States' of America (USA) total health care spending increased from an estimated $1.4 trillion [13.3% of gross domestic product (GDP)] in 1996 to an estimated $3.1 trillion (17.9% of GDP) in 2016. 2 The pharmaceutical expenditure accounts roughly for one-quarter of all healthcare expenditure, and is a significant driver of rising healthcare cost. 3 In Croatia average increase in expenditure for medicines from 2015 to 2019 was 9.8% annually. Even more worrisome is the increase of 15.5% in 2019 compared with 2018. 4 To optimise investment in medicines, hospitals design a hospital medicines policy and use tendering and negotiation processes.The European Parliament approved the new Directive on public procurement in 2014, to provide equal access with fair competition for public contracts within the EU market. 5 Currently, the lowest price procurement strategy, with generic prescribing included, is the most commonly used method by governments and hospitals in optimising investments in medicines. 6

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Limitations of the results from randomized clinical trials involving intravenous and nebulised magnesium sulphate in adults with severe acute asthma

Cited by 5 publications

References 24 publications

Mechanism and Management of Fentanyl-Induced Cough

Mechanism and Management of Fentanyl-Induced Cough

Magnesium sulphate pretreatment obtunds fentanyl-induced cough during general anaesthesia induction

The economic impact of a clinical pharmacist’s involvement in the hospital medicines policy in a rural area

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