Comparison of the efficacy of oral versus intravascular magnesium in the prevention of hypomagnesemia and arrhythmia after cabg

Abstract Objective: Cardiac arrhythmias are a common challenge following open-heart surgeries. Hypomagnesemia is believed to be correlated with this condition. Prophylactic intravenous magnesium supplementation has been practiced for a long time in patients undergoing CABG. This study was designed in an attempt to compare the efficacy of oral versus intravenous routes in the prevention of hypomagnesemia and arrhythmia. Methods: In this interventional clinical study, 82 patients were randomly assigned to 2 groups. All patients were evaluated for baseline serum magnesium level and arrhythmias. One group received 1,600 mg of oral magnesium hydroxide through nasogastric (NG) tube prior to surgery, while the other group received 2 g of magnesium sulfate during the induction of anesthesia. The serum magnesium level was monitored for 48 hours after the operation. The difference in preoperative hypomagnesemia was non-significant (Sig: 0.576). Results: During the operation, the serum magnesium level peaked around 4 mg/dL, and no hypomagnesemia was detected in any patient. Although the curve of oral group declined parallel and below that of intravenous (IV) group, no significant differences were detected during postoperative monitoring. In addition, a prevalence of arrhythmia of 13.9% and 6.5% was noticed in IV and oral groups, respectively (OR: 0.428). Conclusion: Providing 1,600 mg of oral magnesium supplement to patients is as effective as 2,000 mg of magnesium sulfate IV in preventing hypomagnesemia and arrhythmia after CABG. Thus, the authors introduce this treatment regimen as a promising and cost-effective method.

Hydrogen-rich water prepared by hydrogen rods:an experimental study / 军事医学

Objective To verify the efficiency and stability of hydrogen-rich water preparation with hydrogen-rich rods. Methods ①Seven firenew hydrogen-rich rods were separately placed in seven plastic bottles, each filled with distilled water and soaked for 6 h, before the hydrogen concentration of the water was measured.This process was repeated 10 times.②After the hydrogen-rich rods with the strongest and weakest hydrogen product capacity were removed, the remaining 5 hydrogen-rich rods were placed separately into 5 plastic bottles filled with distilled water,put in a water bath pot at 20,40 and 60℃, respectively, and kept for 2, 4, 6, 8 and 10 h, respectively.Then, the hydrogen concentration, oxidation-reduction potential(ORP),and dissolved oxygen concentration(DO) were measured at various time points.③In order to determine the hydrogen emission rate from the hydrogen-rich water, the hydrogen-rich rods were constantly kept in some samples and the others were removed.All the sample bottle caps were kept open during the experimental process, and the hydrogen concentration was measured at such time points as 0, 10 and 30 min, 1, 2, 5, 12, 24, 30, 48 and 72 h, respectively.Results ①The hydrogen-rich rods used in this study could well meet the requirements.②When the environment temperature was kept constant, the hydrogen concentration of the water was increased with the soaking time of the hydrogen-rich rods, and the ORP of the water was reduced.However, the DO of the water was decreased with the rise of the environment temperature.③When the hydrogen-rich water was kept in opened plastic bottles with a 25 mm oral diameter, the hydrogen concentration of the samples with the hydrogen-rich rods reserved was almost about 0.50 ppm until 72 h, and that of the others was reduced to almost 0 ppm.Conclusion Our results demonstrate that the hydrogen-rich rods test is a simple and effective method for preparing hydrogen-rich water, which will be an valuable and useful method for using hydrogen-rich water in health promotion and prevention of chronic diseases.

The Effect of Electrolyte Concentration and Polymer Content on the Rheological Behavior of Magnesium Hydroxide Suspension.

Aims: Magnesium hydroxide (Mg (OH)2) is an alkaline compound that is used as an anti-acid and laxative agent. The objective of the study was to find the effect of electrolyte concentration and polymers on the rheological behavior of Mg (OH)2 suspension. Place and Duration of Study: Department of Pharmaceutics, Faculty of Pharmacy and Nanotechnology Research Center Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Methodology: To evaluate the effect of structural vehicle, some suspending agents such as carboxymethyl cellulose (CMC), polyvinyl pyrrolidone (PVP), tragacanth and magnesium aluminum silicate (Veegum) alone or in combination were utilized. NaCl (0.01 and 0.05 wt/vol %) was employed as flocculating agents. Physical stability parameters such as sedimentation volume, and the ease of redispersion of the suspensions were evaluated. After incorporation of structural vehicles, the rheological properties of formulations were also studied to find out their rheological behavior. Results: The results showed that the combination of suspending agents had the most physical stability and pseudoplastic behavior with some degree of thixotropy. NaCl as flocculating agent (0.01 wt/vol %) in formulations containing tragacanth and CMC improved the rheological behavior of suspensions and sedimentation volume, while the presence of PVP could not affect these properties. Conclusion: The results showed that viscosity and thixotropy measurement are a reliable factor to study suspension stability.

Farmacovigilancia de interacciones medicamentosas en pacientes afiliados al sistema de salud de Colombia / Drug surveillance of medication interactions in patients affiliated to the health system in Colombia

Objetivos: determinar las posibles interacciones medicamentosas que generen problemas relacionados con medicamentos de seguridad, necesidad o efectividad, mediante la búsqueda activa en bases de datos de pacientes afiliados al Sistema General de Seguridad Social en Salud.Métodos: a partir de las bases de datos de dispensación de medicamentos deAudifarma S.A, a unos 3,7 millones de usuarios del país, se hizo una revisiónsistemática de estadísticas de una serie de medicamentos identificados porpresentar interacciones.Resultados: del total de pacientes que tomaban omeprazol se encontró que 12,3 porciento recibían concomitantemente hidróxido de magnesio mas aluminio; 1,7 porciento recibían ranitidina; 1,0 porciento sucralfato, además 0,3 porciento tomaban simultáneamente omeprazol+ sucralfato + hidróxido de magnesio y aluminio y 0,4 porciento omeprazol + ranitidina + hidróxido de magnesio y aluminio, que no potencian el efecto antiulceroso o pueden antagonizar sus acciones. También se halló que el 0,2 porciento de pacientes que tomaban verapamilo recibían al mismo tiempo digoxina o metil digoxina con riesgo de aumentar la toxicidad y antagonizar el efecto inotrópico. Todos los casos fueron notificados a los responsables de su atención sanitaria.Discusión: interacciones medicamentosas representan un riesgo potencial, el cual debe ser tenido en cuenta por los médicos prescriptores. La fármacovigilancia permite optimizar recursos y prevenir eventos adversos que puedan potencialmente causar morbilidad o letalidad. Se recomienda considerar la búsqueda en bases dedatos para reforzar los programas de vigilancia de uso de medicamentos en el país.

Objectives: to determine the possible medication interactions that generateproblems related to safety medications, needs or effectiveness, throughout theactive search in data bases of patients affiliated to the General Health System of Social Security. Methods: based on the data base from Audifarma S.A. in regards to the distribution of medications to 3.7 million of users in the country, a systematic review of thestatistics of a series of drugs identified for presenting interactions. Results: out of the total of patients that were taking omeprazol, it was found that 12.3% at the same time received magnesium hydroxide plus aluminum; 1.7%received ranitidine; 1.0% sucralfate, and also 0.3% were at the same time taking omeprazol + sucralfate+magnesium hydroxide and aluminum and 0.4% omeprazol + ranitidine+magnesium hydroxide and aluminum, which do not maximize the anti ulcerous effect or may antagonize its actions. It was also found that 0.2% of the patients was taking verapamil and at the same time received digoxin or methyl digoxin with the risk of increasing the toxicity and antagonizing its inotropic effect. All these cases were notified to those responsible for their sanitary attention. Discussion: medication interactions represent a potential risk, which has to be considered by the prescribing doctors. Drug surveillance allows the optimization of resources and the prevention of adverse events which may potentially cause mortality or be lethal. It is recommended that data bases be searched in order to reinforce the surveillance programs in relation to the use of medicines in the country.

Effect of Combination Pretreatment of Polyethylene Glycol Solution and Magnesium Hydroxide for Colonoscopy / 대한소화기학회지

BACKGROUND/AIMS: This study was designed to compare the efficacy and patient tolerance between standard bowel preparation using 4 liters of polyethylene glycol (PEG) solution and 4 liters of PEG preceded by the osmotic laxative, magnesium hydroxide in constipation and non-constipation group. METHODS: 173 outpatient colonoscopy, except for three patients who were not taking magnesium, were divided into constipation and non-constipation group. Then, the patients were randomly assigned to receive 4-liter of PEG solution or 4-liter of PEG plus magnesium hydroxide. The quality of bowel preparation was assessed using Ottawa scale, and satisfaction score was assessed using questionnaires. Solid stool, cecal intubation time, compliance, and side effects were assessed. RESULTS: Non-constipation group showed no significant differences between two groups. In constipation group, 4-liter PEG solution plus magnesium hydroxide induced the more effective colonic preparation (Ottawa scale 2.47+/-0.99 vs. 5.92+/-2.39, p<0.05), and less solid stool (0.67+/-0.72 vs. 1.38+/-0.65, p<0.05) compared with 4-liter PEG solution. CONCLUSIONS: Bowel preparation with magnesium hydroxide and 4 liters of PEG solution might reduce solid stool in constipation group, but could not improve preparation quality.

Effects of Magnesium Hydroxide on Disintegration Time and Dissolution Rate of Diclofenac Sodium Plain Tablet.

The objective of this study was to evaluate the effects of magnesium hydroxide (MH) on disintegration time (DT) and dissolution profile of diclofenac sodium (DS) plain tablet. The tablets of DS were formulated with conventionally used excipients and investigational agent Mg [OH] 2. Different parameters of tablets like hardness, thickness, friability, and disintegration time and dissolution rate were determined to assess the effects of MH on these parameters. The physical resistance against abrasion or shock of DS-MH tablets had been noticed by the results of hardness and friability test which were within the limits of standard specification. The disintegration times of tablets of the experimental batches except one, found 2.0 to 25 minutes were also within the limits of standard specification. The release rates of DS in simulated gastric fluid (SGF) at 30 minutes were inspiring about batches FO3: 84.78% and FO4: 90.38%. A positive correlation of coefficient determined between quantity of Mg(OH)2 in different batches of tablets and their effects on dissolution rate was found statistically significant (r = 0.66). The tmax of DS was not affected by the presence or increment of MH as evident in r tmax= 0.50. The overall study indicated that Magnesium hydroxide didn’t affect the different physical parameters of plain tablet rather it in certain quantity while present in some batches assisted rapid disintegration and release profile of active content Diclofenac sodium. The DS-MH plain tablet to provide rapid disintegration, dissolution and absorption hence fastest antiinflammatory action with acid neutralizing benefits by MH, might be considered sincerely