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Emil M. Skobeloff; William H. Spivey, MD; Robert M. McNamara, MD; Lee Greenspon, MD

JAMA. 1989;262(9):1210-1213.

Abstract
Conventional nebulized β-agonist therapy has met with disappointing results in an increasing number of moderate to severe asthmatics who may be characterized as "poor responders." Thirty-eight patients suffering from acute exacerbations of moderate to severe asthma were treated in an emergency department with an intravenous infusion of saline placebo or 1.2 g of magnesium sulfate after conventional β-agonist therapy failed to produce significant improvement in peak expiratory flow rate. Nineteen patients were randomized into each of two groups in a placebo-controlled, double-blind clinical trial. The treatment group demonstrated an increase in peak expiratory flow rate from 225 to 297 L/min as compared with 208 to 216 L/min seen in the placebo group. In addition, the number admitted vs discharged was significantly better for the treatment group (7 vs 12) than the placebo group (15 vs 4). Intravenous magnesium sulfate may represent a beneficial adjunct therapy in patients with moderate to severe asthma who show little improvement with β-agonists.

(JAMA. 1989;262:1210-1213)

Author Affiliations
From The Medical College of Pennsylvania (Mr Skobeloff [medical student]) and its Departments of Emergency Medicine (Drs Spivey and McNamara) and Internal Medicine (Dr Greenspon), Philadelphia.

Footnotes
Reprint requests to The Medical College of Pennsylvania, Department of Emergency Medicine, 3300 Henry Ave, Philadelphia, PA 19129 (Dr Spivey).

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