A randomized clinical trial of nebulized magnesium sulfate in addition to albuterol in the treatment of acute mild-to-moderate asthma exacerbations in adults.
OBJECTIVE
We sought to compare the efficacy and safety of nebulized magnesium sulfate (MgSO(4)) plus albuterol with that of albuterol alone in adult patients with mild-to-moderate acute asthma exacerbations.


METHODS
Patients were randomized to receive nebulized MgSO(4) (384 mg in 6 mL of sterile water) or an equal volume of placebo (normal saline solution) in a double-blind fashion after each dose of nebulized albuterol administered (2.5 mg/3 mL) every 20 minutes for the first hour of the study. Spirometry was performed at baseline and every 20 minutes for 2 hours. Monitoring for safety included vital signs, pulse oximetry, and serum magnesium levels. Improvement in percent predicted forced expiratory volume in 1 second was chosen as a primary efficacy end point.


RESULTS
Among 74 patients enrolled, 37 were randomized to each of 2 study groups. There were no statistically or clinically significant differences between the 2 study groups in percent predicted forced expiratory volume in 1 second at any point during the trial or overall. There were no significant differences in vital signs, pulse oximetry, or serum magnesium levels at any point during the study.


CONCLUSIONS
The combination of nebulized MgSO(4) and albuterol provides no benefit in addition to that provided by therapy with albuterol in adult patients with mild-to-moderate asthma exacerbations. The efficacy of nebulized MgSO(4) in patients with severe asthma exacerbations remains unknown.
Bessmertny
Olga
O
Long Island University, Arnold and Marie Schwartz College of Pharmacy, Brookdale University Hospital and Medical Center, Brooklyn, NY 11212-3198, USA.
DiGregorio
Robert V
RV
Cohen
Henry
H
Becker
Ellen
E
Looney
Darrell
D
Golden
Jonathan
J
Kohl
Lewis
L
Johnson
Thomas
T
D000280:Administration, Inhalation; D000328:Adult; D000420:Albuterol / Q000627:therapeutic use*; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009330:Nebulizers and Vaporizers
D000700:Analgesics; D001993:Bronchodilator Agents; D008278:Magnesium Sulfate; D000420:Albuterol