Magnesium Sulfate for Acute Asthma Exacerbation

acute-asthma

Intravenous magnesium sulfate given as a single dose of 1.2 g or 2 g over 15 to 30 minutes improves lung function and reduces the risk of hospital admission in adults with acute asthma exacerbations that have not resolved with current first line treatments.

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Coke Bottle named Asthma

Home made coca cola spacer

Metered-dose inhalers with a spacer can perform at least as well as nebulisation in delivering beta-agonists in children with acute asthma. Salbutamol has systemic side effects – tremor and increased pulse rate were more common when using nebulisers.

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Mild to Moderate Acute Asthma Attack…

Most DO NOT need a chest X-ray performed and a high WBC is common as a result both of stress as well as steroid use NOT A SIGN OF INFECTION so DON’T order labs or give antibiotics unless there are other features of infection.

Magnesium sulfate for moderate to severe asthma exacerbation

magnesium-asthma

If inhaled salbutamol and iprotropium (remember, double nebs decrease the risk of admission) plus systemic glucocorticoids don’t help, give IV Magnesium sulfate 50 mg/kg IV over 20 minutes (max dose 2 grams, use this dose for adults)