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Is there an alternative to magnesium sulfate inhalation in children < 2y in case of severe exacerbation not responding to usual regimen?
suggest using intravenous magnesium sulfate in infants and children with severe asthma exacerbations and in children with moderate to severe asthma exacerbations who have not responded to initial treatment with beta-agonists, ipratropium bromide, and systemic glucocorticoids.
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr. Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature. Ann Emerg Med. 2000 Sep;36(3):181-90. doi: 10.1067/mem.2000.105659. PMID: 10969218.
Griffiths B, Kew KM. Intravenous magnesium sulfate for treating children with acute asthma in the emergency department. Cochrane Database Syst Rev. 2016 Apr 29;4(4):CD011050. doi: 10.1002/14651858.CD011050.pub2. PMID: 27126744; PMCID: PMC6599814.
IV: 50 mg/kg/dose as a single dose; usual dose range: 25 to 75 mg/kg/dose; maximum dose: 2,000 mg/dose;
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Becker SM, Job KM, Lima K, et al. Prospective study of serum and ionized magnesium pharmacokinetics in the treatment of children with severe acute asthma. Eur J Clin Pharmacol. 2019;75(1):59‐66. doi:10.1007/s00228-018-2557-7[PubMed 30259065]
What indication we are talking about? Is it acute refractory asthma exacerbation?