Management of Asthma with Magnesium - Literature review Example

Running Head: MANAGEMENT OF ASTHMA WITH MAGNESIUM Management of asthma with magnesium Name Institution Date Management of asthma with magnesium Introduction Asthma is among the widespread conditions among children and grown up people. The identification of as an inflammatory ailment has led to a greater shift in pharmacotherapy. The previous emphasis which entailed the use of short-acting agents for relieving bronchospasms has changed towards long term strategies. The use of inhaled corticosteroids is slowly and gradually being adopted. It prevents and abolishes airway inflammation. The paper critically looks at how the disease is managed using magnesium and the resultant effects. Justification Asthma is a disease characterized by convulsive narrowing of the bronchia airways because of inflammation and contraction of the bronchi and its smooth muscles respectively. The inflammation may be due to pathogenesis of symptoms such as dyspnea, wheezing and coughing. Acute asthma is commonly caused by infections in the upper respiratory tract, getting exposed to allergens such as dust mites, inhaling smoke, cold and dry weather. During an Asthma attack, the airways become narrow making breathing to be difficult. The airways get swollen and they become tight. This limits the flow of air form the lungs. Naturally, the lungs are protected by mucus in the nose. But during an asthma attack, the nose may hold excessive mucus trapping particles contained in the air that is breathed. This may accelerate the asthma attack. The identification of asthma as an inflammatory disease has for the last twenty years has led to a change in its treatment and the drugs used. This was also following the highly advancing knowledge on its pathophysiology that was counteracted by increase in its morbidity and mortality. Brenner (2010) explains that the number of people who died as a result of asthma in the United States increase from 13 to 19 deaths per million people between the years 1982 and 1991. However, this has been on decline following recent increase in focus on the treatment of asthma. To help stop the rate of increase in its severity, both the physicians and the patients must concentrate more identifying it on time and early treatment (O'Byrne & Thomson, 2001). Search for other means of treating asthma such as magnesium has also been important due to the high rate of increase in its incidences. Brenner (2010) states that the number of people who are developing the illness for one year are approximately 0.2 to 0.4 percent in the United States. These are incidences in childhood and half of them continue even into adulthood. More than 25 million people in the world are suffering from asthma (Murphy, & Kelly,1999). Sometimes managing asthma may become difficult to the physician. The main goal in treatment of people with respiratory breakdown is to bring back the patient to his or her normal breathing state and curbing the complications. This can only be achieved by use of drugs. One of the current strategies that have been adopted in the treatment of asthma is use of intravenous (IV) magnesium sulfate (MgSO4) Aikawa, 2001). According to Seelig & Rosanoff, (2003).Magnesium is a minor mineral that is required for the functioning of several processes in the body. Most of the symptoms of some chronic body disorders such as asthma have been found to be similar to those of magnesium deficiency. Studies show that many people in the world do not take the required amount of magnesium per day and this has been found to be a cause of the high rates of development of asthma and other respiratory illnesses. Magnesium deficiency may therefore offer an explanatory for the occurrence of many diseases in the world (Morrow, 2010). Management of asthma with magnesium began long in 1930s. Magnesium helps the asthma patients to breathe more easily and is widely used in the emergency rooms. Doctors have also recommended dietary supplementation with magnesium to stabilise its levels in the body (Gulledge, Beard, & Health and Administration Development Group, 1998). . Evidence based practice Use of Intravenous (IV) magnesium sulfate (MgSO4) has proved to be successful in treatment of acute asthma. Evidence has shown that intravenous magnesium can add to bronchodilation when administered together a standard gent for bronchodilation and corticosteroids (Behera, 2005). Another reason for use of magnesium in management of asthma is because increase in drug resistance and non respondence in most of asthma patients. Magnesium therefore helps to improve the pulmonary function in the non-responding patients. Intravenous magnesium has also been found to work faster than the corticosteroid therapy (Devi, 1997). Use of magnesium in management of asthma has been proven effective by a considerable source of epidemiological evidence. According to Britton, Pavord, and Richards, (1998), intake of dietary magnesium has been indicated to be an independent cause of constriction of the soft muscles of the bronchi mostly in adults. Reduction of magnesium stores in the body may be a contributing factor in the development of asthma attacks. According to Okayama & Aikawa, (1998) administration of the intravenous magnesium sulphate may help to improve the bronchodilation as well as the air flow in the bronchi. This is also supported by Skobeloff & Spivey, (1999) who says that patients having the most severe air obstruction can be helped by giving them intravenous magnesium sulphate as it has also been shown to reduce the patient’s admission to hospital. Rowe et al (2000) argues that given the safety and better tolerance of magnesium, it can be used together with an insistent medical regime during the treatment of acute asthma. The functioning of magnesium is based on its ability to relax the smooth muscles on the bronchi. Combination of isotonic form of magnesium with an asthma drug known as sulbutamol applied in spray form has also been found to be very effective in helping patients to recover immediately from asthma attacks (Skorodin, 1995). A study published in the Brown University in the United Kingdom indicated that people take diets that have low amounts of magnesium develop more asthma symptoms unlike those who eat foods higher in magnesium. This is because magnesium prevents pre-asthmatic lung changes according to the study (Rowe, 2000). Asthma has also been found to be common among individuals who suffer from disorders of the connective tissues such as keratoconus, mitral valve prolapes and rachitic skeletal defects. These are the diseases associated with deficiency of magnesium (Clark, & Rees, 1999). Asthma can also be found in people having other conditions such as allergies, and seizures, all associated with deficiency of magnesium. Multivitamin usage has also been associated with asthma. The National Institutes of Health (2002) in the United States explains that multivitamin tables do not contain magnesium due to its bulkiness and may make the tablet to have a very large size. The manufacturers of multivitamin therefore do not include magnesium in the tablet. On the other hand, multivitamin contain several magnesium antagonists which may lower the availability of magnesium in the body. This has therefore resulted in magnesium deficiency among people who use multivitamin (Theophanides, 2000). Several clinical tests have been done to determine the effect of intravenous magnesium on people having acute asthma. Trials that were placebo controlled were done on adults in the United States (Rowe, 2000). The patients were found not to respond to the usual treatment given in the emergency room but their lung function improved later when they were given intravenous magnesium sulphate unlike in the placebo. However, administration of intravenous magnesium was found to be more effective to those patients with a severe acute asthma attack unlike those with just an acute attack (Skobeloff, 1999). According to the British Guidelines for Treatment of Asthma, a single dose of magnesium can help for those patients having acute severe asthma or those not responding to o bronchodilator can help. However, the guidelines state that magnesium is not recommended for treatment of children between two to five years (British Thoracic Society, 2003) Evidence on the rationale for use of magnesium treatment of asthma is provided by Britton et al, (1998) who says that magnesium is stored entirely in the intracellular, that is, in the bone and muscles, and it is removed from the body through the kidneys. Therefore, adults who take enough magnesium in their diets have their lungs functioning better and experience lower cases of wheezing that those who do not take enough dietary magnesium. This is also supported by Bois (1998) who says that this is possible due to the ability of magnesium to relax the bronchial smooth muscles preventing the release of acetylcholine from the neuromuscular joints and thus stabilising the mast cells. Cartmell, (2010) says that magnesium mineral plays a very crucial function in the health of all humans especially those suffering from asthma attack. Magnesium has been shown to cut down the symptoms of asthma in people who have already developed the disease since it acts as an effective preventive measure when taken daily. According to the National Health & Nutrition Survey of 1999-2000, most people suffer form deficiency of magnesium in their bodies. Low level of magnesium in the body leads to high production of histamine in the blood and these high levels of histamine leads to asthma attacks (NCEA, 2000) Great Britain University revealed that deficiency of magnesium in human bodies is a major cause of magnesium. When the levels of magnesium in the body are returned to normal, the lung function increases reducing symptoms such as wheezing (Cartmell, 2010). A British founded website, Patient UK, (2010), the bronchial muscles go into a seizure during an asthma attack hence blocking the airways and limiting proper breathing. When magnesium is introduced in the body, the bronchial muscles smoothen and the airways open immediately. To achieve proper levels of magnesium in the body, intake of magnesium supplements of between 200 and 600mg per day can help stop asthma symptoms (Nishizawa, & Morii,2007). Research has proved that deficiency of magnesium can cause asthma and at the same time an intravenous injection of magnesium can stop the most acute asthma attack immediately it is given. Research done at the University of Nottingham revealed that more than 2,600 people who had been taking more than the average magnesium intake of 380mg per day had a better functioning lung system and had less symptoms of wheezing (Scarfon, 2000). Low levels of magnesium in the blood can cause allergies that result asthma attack. However, some of the drugs that are used in treatment of asthma can lead to depletion of asthma stores in the body. This is the reason why most doctors recommend that one should take between 200 and 600 magnesium supplements per day. However, with adequate dietary intake, people can work without taking the supplements. Weinberger (2006) says that deficiency mostly occurs because of people taking too much of the processed foods and avoiding the whole grains. Magnesium deficiency can also result since there are few areas in the body where it is absorbed. Low levels of acid in the stomach can result in poor absorption of magnesium. Doctors therefore recommend that people should take foods that are rich in magnesium such as the dark green vegetables, pumpkin seeds, millet and nuts. However, asthma is caused mostly by allergies. Those who suffer from asthma attack should minimise their intake of dairy products since they accelerate the development of allergies (Articlebase, 2009). Intravenous Magnesium is also preferred for treatment of asthma in the emergency room because of its safety, it has few side effects and its use cannot prevent the use of other treatment options because it does not have a very strong effect (Clark, & Rees, 1999). Nevertheless, administration of magnesium should be not be exceeded since excess of it may result in diarrhoea and intestinal cramps. Its overdose can also result in failure of the kidneys since they are charged with the role of excreting magnesium. However, overdose of magnesium is a rare incidence unless when people take excess anta acids that contain magnesium (Ciarallo, 2000). Recommendations Weinberger (2006) insists that treatment of asthma should involve intervention and maintenance. Intervention involves taking measures that can stop the acute symptoms of asthma while maintenance involves preventing the symptoms from occurring. All patients should be given effective intervention measures that make it easy to anticipate incoming symptoms so that anti inflammatory drugs can be given. For an acute care clinical setting, it would be recommended that corticosteroids be available at all the times in the hospital and in the patients’ homes for early interventions (DIANE, 2006). In my own clinical setting, I would adopt use of magnesium in managing asthma since research has proved that dietary intake of magnesium can help prevent a person from developing asthma symptoms. It would therefore be better if all people are informed on the importance of dietary intake since it will help their bodies in developing a natural protection (Kohlstadt, 2009). Leong (2010) says that magnesium in the body acts in a manner similar to the asthma inhalers that are used as bronchodilators. It is an anti inflammatory agent and may be offer relief to asthma patients. Research says that magnesium dilates the bronchial tubes that usually constrict in the event of an asthma attack. Magnesium would also be of my preference because long term use of the corticosteroids is not healthy for the body. Patients should instead be able to use normal post bronchodilator pulmonary function after the required intervention has been achieved. However, to ensure that patients are not faced with adverse health effects as a result of asthma medication, it is very necessary to maintain the required magnesium level in the body. This is mostly obtained by taking foods rich in magnesium such as dark green leafy vegetables, nuts, wheat and pumpkins. Another recommendation for asthma a patient is that since asthma attack happens when one is exposed to some allergens, those prone to such an allergic reaction should ensure that they keep off the presence of the allergens. This would be a better role in the maintenance part of treatment since it will prevent the occurrence of those symptoms (Kotses, & Harver, 2000). Proper pharmacological therapy is very important in the general control of asthma. This should be able to reduce the need for hospital admission due to asthma attack, and should also be able to prevent the attack from interfering with the patient’s activities. To achieve this effectively, magnesium intake should be prioritized since research has proven it (DIANE, 2004). References Weinberger, M., (2006). Asthma Management: Guidelines for the Primary Care Physician. Retrieved on 27th July from Leong, K. (2010) Can Magnesium Help The Symptoms of Asthma? Retrieved on 27th July 2010, from Brenner, B. (2010). Asthma. Retrieved on 27th July from < http://emedicine.medscape.com/article/806890-overview> Martin, G., (2004). Magnesium Sulfate in the Treatment of Asthma, retrieved on 27th July from Cartmell, P. (2010). 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