Therapeutic Effect of Adding Magnesium Sulfate in Treatment of Organophosphorus Poisoning

Abstract

BACKGROUND:In recent years, the prevalence of poisoning has increased dramatically due to population growth and access to drugs and toxins. Today poisoning is one of the important reasons for visiting hospitals.AIM:The present study aimed to investigate the effect of magnesium sulfate on organophosphorous toxicity.METHODS:Patients who had inclusion criteria in the study were randomly assigned to one of two groups (control group or case group) by an emergency medicine specialist. Patients’ data including age, sex, ECG, vital signs, arterial oxygen saturation were recorded for patients. Patients in the case group (40 subjects) received 2 mg magnesium sulfate 50%, while the control group (40 subjects) received 100 cc normal saline (as placebo) as an intravenous infusionRESULTS:The distribution of gender in the two groups of patients was the same. Also, the mean age, Stature and weight of patients were similar in both groups. In the group receiving magnesium sulfate, diastolic blood pressure was lower when compared with another group, at 0 and 2 hours after intervention. Moreover, the mean of systolic blood pressure in both groups was determined to be the same at all hours. Furthermore, the heart rate in the group receiving sulfate was lower as compared to the control group for 8 hours, 16 and 24 hours after intervention.CONCLUSION:The use of magnesium sulfate in organophosphate poisoning reduces therapeutic costs an average hospital length of stay and mortality compared to those who did not receive magnesium sulfate.

“Calcium bombs” as harbingers of synaptic pathology and their mitigation by magnesium at murine neuromuscular junctions

“…Trials under way include the search for medications already established for treatment of other conditions that may be repurposed for treatment of ALS ( Mehta et al, 2021 ). Mg 2+ therapies have been reported in previous experimental studies and clinical trials focused on mitigation of OP toxicity ( Bradley, 1986 ; Basher et al, 2013 ; Philomena et al, 2016 ; Vijayakumar et al, 2017 ; Jamshidi et al, 2018 ). The potential efficacy of magnesium has been considered previously in the context of nutrition or treatment of patients with ALS but clinical data from studies of MgSO 4 in both contexts have not been decisive ( Longnecker et al, 2000 ; Pamphlett et al, 2003 ; Fondell et al, 2013 ; Brvar et al, 2018 ; Aman et al, 2021 ; Kumar et al, 2022 ).…”

Impaired neuromuscular function by conjoint actions of organophosphorus insecticide metabolites omethoate and cyclohexanol with implications for treatment of respiratory failure

“…Nevertheless, MgSO 4 therapy has proved clinically effective in treatment of eclampsia [11][12][13]. MgSO 4 therapies for OP poisoning have been reported in several clinical trials [6][7][8][9][10] and is now the subject of our ongoing study (CCBOC RCT; trial registration number NCT03925025).…”

“…At a molecular level, OP pesticides kill insects by inhibiting acetylcholinesterase (AChE) activity, which normally terminates the action of neurotransmitter at cholinergic synapses, including neuromuscular junctions [6][7][8][9][10]. When humans swallow these insecticides, they may experience symptoms and show signs of severe OP poisoning, including pulmonary edema, acute respiratory failure, abnormal weakness in proximal muscles (myasthenia), and neuromuscular synaptic dysfunction [11][12][13].…”

A complete, evidence-based review on novichok poisoning based on epidemiological aspects and clinical management

“…Sulfate Magnesium by inhibiting calcium channels counteracts presynaptic acetylcholine release. A randomized control study in 2017, concluded that the infusion of 4–6 g of 20% MgSO4 solution in 24 h can reduce atropine requirements, intubation quantities, and ICU days in toxicities with OP ( Eddleston and Chowdhury, 2016 ; Vijayakumar et al, 2017 ; Brvar et al, 2018 ; Jamshidi et al, 2018 ).…”