The Adjunctive Effect of Intravenous Magnesium Sulfate in Acute Exacerbation of COPD: A Randomized Controlled Clinical Trial.

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide. Acute exacerbation of COPD (AECOPD) is a serious event during the natural course of the disease. Despite many clinical trials on the management of AECOPD, treatment has not changed significantly during the past decades. Intravenous (IV) magnesium sulfate (MgS04) has been proposed to enhance the bronchodilator effects of inhaled beta2-agonists. Magnesium is involved in many enzymatic processes. It relaxes bronchial smooth muscles through its calcium channel blocking properties and inhibitory effects on the release of acetylcholine from neuromuscular junctions. It also exerts anti-inflammatory effects by attenuating the respiratory neutrophil burst and decreasing histamine release from mast cells.