Protective Effects of Intravenous Magnesium Sulfate in Stroke Patients Receiving Amiodarone: A Randomized Controlled Trial.

Yunes Panahi, Mojtaba Mojtahedzadeh, Atabak Najafi, Mohammadreza Gheini, Mohammad Abdollahi, Mohammad Sharifzadeh, Arezoo Ahmadi, Shiva Ganjali, Seyyed Mahdi Rajaee, George E Barreto, Amirhossein Sahebkar

Journal: Advances in experimental medicine and biology 2021;1308():579-588

PMID: 33861459

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Abstract

Anti-arrhythmic agents, like amiodarone, interfere at different stages of the ischemic stroke. However, amiodarone was accompanied with immunological pulmonary complications and adverse neurological effects. We hypothesize that magnesium sulfate in combination with amiodarone holds promise for stroke treatment. Thirty-six patients with confirmed diagnosis of ischemic stroke and atrial fibrillation who received bolus amiodarone were randomly assigned to magnesium sulfate every 24 h or similar volume of normal saline (as placebo) for 5 days. Various severity test scores were used to evaluate the symptoms. Routing biochemistry were also measured at days 1 and 5. Treatment with MgSO4 results in a significant reduction in serum levels of NGAL, Hb, T.Bill, IL-6, IL-8, SNSE, S100B, EGF, PAF, CRP and IgG. Also, MgSO4 treatment significantly improved the RASS, Candida, SOFA, NIHSS and APACHE scores. Moreover, reduction of IL-6, IL-8, SNSE, EGF and APACHE score and increase in RASS score were significantly higher in MgSO4 group compared with placebo. Intravenous administration of MgSO4 in amiodarone-treated stroke patients improved the inflammatory, immunological and neurological indicators and reduced disability in ICU-admitted AIS patients, suggesting that this treatment scheme may prevent amiodarone-induced complications in these patients.

Address: Pharmacotherapy Department, School of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran.; Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.; Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.; Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.; Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.; Department of Neurosurgery and Neurology, Sina Hospital, Tehran University, Tehran, Iran.; Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.; Department of Medical Biotechnology and Nanotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Tehran, Iran.; Gastrointestinal Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.; Department of Biological Sciences, University of Limerick, Limerick, Ireland.; Health Research Institute, University of Limerick, Limerick, Ireland.; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. [email protected].; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. [email protected].; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. [email protected].; Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland. [email protected].

DOI: 10.1007/978-3-030-64872-5_28