Dose optimization of intravenous magnesium sulfate after acute stroke
Parenterally administered MgSO4 is neuroprotective in standard animal models of focal cerebral ischemia and in many other paradigms of brain injury. Previous small clinical trials in stroke patients have explored the safety and tolerability of different infusion regimens. This study was undertaken t...
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| Veröffentlicht in: | Stroke (1970) 1998-05, Vol.29 (5), p.918-923 |
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| container_title | Stroke (1970) |
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| creator | MUIR, K. W LEES, K. R |
| description | Parenterally administered MgSO4 is neuroprotective in standard animal models of focal cerebral ischemia and in many other paradigms of brain injury. Previous small clinical trials in stroke patients have explored the safety and tolerability of different infusion regimens. This study was undertaken to optimize the regimen for a multicenter trial.
Within 24 hours of the onset of clinically diagnosed stroke, patients were randomized to receive placebo or one of three intravenous MgSO4 infusions: a loading infusion of 8, 12, or 16 mmol, followed by 65 mmol over 24 hours. Cardiovascular parameters, serum magnesium concentrations, and blood glucose concentrations were determined. Outcome at 30 and 90 days was recorded.
Twenty-five patients were recruited and treated at a mean time of 20 hours after stroke. No tolerability problems were identified. No effects of magnesium on heart rate, blood pressure, or blood glucose were evident. Serum magnesium concentrations rose to target levels most rapidly in the highest loading infusion group and were maintained in all groups for at least 24 hours.
MgSO4 infusions that rapidly elevate the serum magnesium concentration to potentially therapeutic levels are well tolerated and have no major hemodynamic effects in patients with acute stroke. The 16-mmol loading infusion achieved target serum concentrations most rapidly and has been chosen for further trials. |
| doi_str_mv | 10.1161/01.STR.29.5.918 |
| format | Article |
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Within 24 hours of the onset of clinically diagnosed stroke, patients were randomized to receive placebo or one of three intravenous MgSO4 infusions: a loading infusion of 8, 12, or 16 mmol, followed by 65 mmol over 24 hours. Cardiovascular parameters, serum magnesium concentrations, and blood glucose concentrations were determined. Outcome at 30 and 90 days was recorded.
Twenty-five patients were recruited and treated at a mean time of 20 hours after stroke. No tolerability problems were identified. No effects of magnesium on heart rate, blood pressure, or blood glucose were evident. Serum magnesium concentrations rose to target levels most rapidly in the highest loading infusion group and were maintained in all groups for at least 24 hours.
MgSO4 infusions that rapidly elevate the serum magnesium concentration to potentially therapeutic levels are well tolerated and have no major hemodynamic effects in patients with acute stroke. The 16-mmol loading infusion achieved target serum concentrations most rapidly and has been chosen for further trials.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.29.5.918</identifier><identifier>PMID: 9596235</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Acute Disease ; Aged ; Anticonvulsants - administration & dosage ; Anticonvulsants - therapeutic use ; Biological and medical sciences ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Cerebral Hemorrhage - drug therapy ; Cerebral Infarction - drug therapy ; Cerebrovascular Disorders - blood ; Cerebrovascular Disorders - drug therapy ; Diastole ; Double-Blind Method ; Female ; Heart Rate - drug effects ; Heart Rate - physiology ; Humans ; Hypotension - etiology ; Injections, Intravenous ; Magnesium - blood ; Magnesium Sulfate - administration & dosage ; Magnesium Sulfate - therapeutic use ; Male ; Medical sciences ; Neuropharmacology ; Neuroprotective agent ; Pharmacology. Drug treatments ; Systole ; Time Factors ; Treatment Outcome</subject><ispartof>Stroke (1970), 1998-05, Vol.29 (5), p.918-923</ispartof><rights>1998 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. May 1998</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-7dc9a9c59d7f2a03e2a01e4d056749283da36ca2c25f6c53f99fd3d3f1dbc9073</citedby><cites>FETCH-LOGICAL-c424t-7dc9a9c59d7f2a03e2a01e4d056749283da36ca2c25f6c53f99fd3d3f1dbc9073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2234939$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9596235$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MUIR, K. W</creatorcontrib><creatorcontrib>LEES, K. R</creatorcontrib><title>Dose optimization of intravenous magnesium sulfate after acute stroke</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Parenterally administered MgSO4 is neuroprotective in standard animal models of focal cerebral ischemia and in many other paradigms of brain injury. Previous small clinical trials in stroke patients have explored the safety and tolerability of different infusion regimens. This study was undertaken to optimize the regimen for a multicenter trial.
Within 24 hours of the onset of clinically diagnosed stroke, patients were randomized to receive placebo or one of three intravenous MgSO4 infusions: a loading infusion of 8, 12, or 16 mmol, followed by 65 mmol over 24 hours. Cardiovascular parameters, serum magnesium concentrations, and blood glucose concentrations were determined. Outcome at 30 and 90 days was recorded.
Twenty-five patients were recruited and treated at a mean time of 20 hours after stroke. No tolerability problems were identified. No effects of magnesium on heart rate, blood pressure, or blood glucose were evident. Serum magnesium concentrations rose to target levels most rapidly in the highest loading infusion group and were maintained in all groups for at least 24 hours.
MgSO4 infusions that rapidly elevate the serum magnesium concentration to potentially therapeutic levels are well tolerated and have no major hemodynamic effects in patients with acute stroke. The 16-mmol loading infusion achieved target serum concentrations most rapidly and has been chosen for further trials.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Anticonvulsants - administration & dosage</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Pressure - drug effects</subject><subject>Blood Pressure - physiology</subject><subject>Cerebral Hemorrhage - drug therapy</subject><subject>Cerebral Infarction - drug therapy</subject><subject>Cerebrovascular Disorders - blood</subject><subject>Cerebrovascular Disorders - drug therapy</subject><subject>Diastole</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Hypotension - etiology</subject><subject>Injections, Intravenous</subject><subject>Magnesium - blood</subject><subject>Magnesium Sulfate - administration & dosage</subject><subject>Magnesium Sulfate - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neuropharmacology</subject><subject>Neuroprotective agent</subject><subject>Pharmacology. Drug treatments</subject><subject>Systole</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkM1LxDAQxYMo67p69iQUEW_t5qNpO0dZ1w9YEHQ9h2yaSNe2WZNU0L_eiGUPXmYG3m8ej4fQOcEZIQWZY5K9rJ8zChnPgFQHaEo4zdO8oNUhmmLMIKU5wDE68X6LMaas4hM0AQ4FZXyKlrfW68TuQtM13zI0tk-sSZo-OPmpezv4pJNvvfbN0CV-aI0MOpEmaJdINcTbB2ff9Sk6MrL1-mzcM_R6t1wvHtLV0_3j4maVqpzmIS1rBRIUh7o0VGKm4yA6rzEvyhxoxWrJCiWpotwUijMDYGpWM0PqjQJcshm6_vPdOfsxaB9E13il21b2OmYVJVQlIwRH8PIfuLWD62M2QaCsaIGhitD8D1LOeu-0ETvXdNJ9CYLFb7sCExHbFRQEF7Hd-HEx2g6bTtd7fqwz6lejLr2SrXGyV43fY5SyHBiwH2nLgkY</recordid><startdate>19980501</startdate><enddate>19980501</enddate><creator>MUIR, K. W</creator><creator>LEES, K. R</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>19980501</creationdate><title>Dose optimization of intravenous magnesium sulfate after acute stroke</title><author>MUIR, K. W ; LEES, K. R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-7dc9a9c59d7f2a03e2a01e4d056749283da36ca2c25f6c53f99fd3d3f1dbc9073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Anticonvulsants - administration & dosage</topic><topic>Anticonvulsants - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Pressure - drug effects</topic><topic>Blood Pressure - physiology</topic><topic>Cerebral Hemorrhage - drug therapy</topic><topic>Cerebral Infarction - drug therapy</topic><topic>Cerebrovascular Disorders - blood</topic><topic>Cerebrovascular Disorders - drug therapy</topic><topic>Diastole</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Hypotension - etiology</topic><topic>Injections, Intravenous</topic><topic>Magnesium - blood</topic><topic>Magnesium Sulfate - administration & dosage</topic><topic>Magnesium Sulfate - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neuropharmacology</topic><topic>Neuroprotective agent</topic><topic>Pharmacology. Drug treatments</topic><topic>Systole</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MUIR, K. W</creatorcontrib><creatorcontrib>LEES, K. R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MUIR, K. W</au><au>LEES, K. R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dose optimization of intravenous magnesium sulfate after acute stroke</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>1998-05-01</date><risdate>1998</risdate><volume>29</volume><issue>5</issue><spage>918</spage><epage>923</epage><pages>918-923</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Parenterally administered MgSO4 is neuroprotective in standard animal models of focal cerebral ischemia and in many other paradigms of brain injury. Previous small clinical trials in stroke patients have explored the safety and tolerability of different infusion regimens. This study was undertaken to optimize the regimen for a multicenter trial.
Within 24 hours of the onset of clinically diagnosed stroke, patients were randomized to receive placebo or one of three intravenous MgSO4 infusions: a loading infusion of 8, 12, or 16 mmol, followed by 65 mmol over 24 hours. Cardiovascular parameters, serum magnesium concentrations, and blood glucose concentrations were determined. Outcome at 30 and 90 days was recorded.
Twenty-five patients were recruited and treated at a mean time of 20 hours after stroke. No tolerability problems were identified. No effects of magnesium on heart rate, blood pressure, or blood glucose were evident. Serum magnesium concentrations rose to target levels most rapidly in the highest loading infusion group and were maintained in all groups for at least 24 hours.
MgSO4 infusions that rapidly elevate the serum magnesium concentration to potentially therapeutic levels are well tolerated and have no major hemodynamic effects in patients with acute stroke. The 16-mmol loading infusion achieved target serum concentrations most rapidly and has been chosen for further trials.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>9596235</pmid><doi>10.1161/01.STR.29.5.918</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Acute Disease Aged Anticonvulsants - administration & dosage Anticonvulsants - therapeutic use Biological and medical sciences Blood Glucose - drug effects Blood Glucose - metabolism Blood Pressure - drug effects Blood Pressure - physiology Cerebral Hemorrhage - drug therapy Cerebral Infarction - drug therapy Cerebrovascular Disorders - blood Cerebrovascular Disorders - drug therapy Diastole Double-Blind Method Female Heart Rate - drug effects Heart Rate - physiology Humans Hypotension - etiology Injections, Intravenous Magnesium - blood Magnesium Sulfate - administration & dosage Magnesium Sulfate - therapeutic use Male Medical sciences Neuropharmacology Neuroprotective agent Pharmacology. Drug treatments Systole Time Factors Treatment Outcome |
| title | Dose optimization of intravenous magnesium sulfate after acute stroke |
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