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What is the stability of magnesium sulphate after opening ampoule and after dilution with normal saline or dextrose 5% ?
As I take 1ml of magnesium sulphate and diluted in 3ml of normal saline/6hr as nebulizer
1. Regarding the Inhalation:
You should know that the MgSO4 available in Egypt usually is 10% that is hypertonic and is not suitable for inhalation and must be diluted to be isotonic before use.
Magnesium sulphate solution 7.5% (w/v) is isotonic
In conclusion, your preparation of 1 part 10% MgSO4 plus 3 part NS is roughly isotonic preparation.
I have no solid evidence to support your regular use every 6 hrs.
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MgSO4 inhalation: Severe exacerbation: Limited data available: Children ≥2 years and Adolescents: Nebulized 150 mg isotonic magnesium sulfate mixed with albuterol and ipratropium every 20 minutes for 3 doses in the first hour of treatment to patients with severe acute asthma who did not respond to standard inhalation treatment (GINA 2020; Powell 2013). In a large randomized, placebo-controlled trial (n=508, including 252 who received magnesium sulfate treatment; ages: 2 to 16 years) improvement was statistically significant, but clinically significant changes were only observed in the most severe patients (SaO2 <92% with symptoms lasting <6 hours) (Powell 2013).
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2. Regarding the stability:
You should differentiate between physicochemical stability and microbiological stability.
2.a. physicochemical stability with NS or D5W is well documented on two studies,
2.b. microbiological stability will vary depending on the premises, for example if preparation area lower than ISO class 5 is used, then the stability must not exceed 3 days in refrigerator and 24 hr on room temperature.