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. 2025 Jun;12(2):110-120.
doi: 10.15441/ceem.23.179. Epub 2024 Apr 5.

The key role of magnesium sulfate in the management of organophosphorus pesticide poisoning: a scoping literature review

Zahra Nekoukar  1 , Homa Talabaki  2 , Zakaria Zakariaei  3 , Mahdi Mesri  4 , Hossein Azadeh  5
Affiliations

The key role of magnesium sulfate in the management of organophosphorus pesticide poisoning: a scoping literature review

Zahra Nekoukar et al. Clin Exp Emerg Med. 2025 Jun.

Abstract

Organophosphorus agents are easily absorbed via respiratory, gastrointestinal, and dermal routes, and inhibit the acetylcholine transferase enzyme, which is responsible for the majority of toxicity caused by organophosphates in the body. A comprehensive search was conducted across three prominent databases (Google Scholar, PubMed, and Science Direct) to identify relevant articles. The search focused on the keywords "MgSO4" or "magnesium sulfate" in conjunction with "organophosphate" or "organophosphate poisoning." Inhibition of acetylcholine transferase enzyme results in the accumulation of acetylcholine in synapses and the stimulation of cholinergic receptors. As several studies have shown that magnesium sulfate (MgSO4) can inhibit the release of acetylcholine in the central and peripheral sympathetic and parasympathetic synapses, this study reviews the role of MgSO4 in the treatment of organophosphorus poisoning. The intravenous administration of MgSO4 exhibits favorable tolerability and clinical efficacy in alleviating cardiac toxicity associated with organophosphorus poisoning.

Keywords: Acetylcholinesterase; Cholinergic receptors; Magnesium sulfate; Organophosphate poisoning.

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Conflict of interest statement

Conflicts of interest

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Inhibition of acetylcholinesterase (AChE) by organophosphate poisoning (OP) and aging process.
Fig. 2.
Fig. 2.
Flowchart of the study.
See this image and copyright information in PMC

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