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Difference between revisions of "Hypermagnesemia"
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*Magnesium is an effective calcium channel blocker both extracellularly and intracellularly<ref>Rizzo MA, Fisher M, Lock JP. Hypermagnesemic pseudocoma. Arch Intern Med. 1993;153(9):1130.</ref> | *Magnesium is an effective calcium channel blocker both extracellularly and intracellularly<ref>Rizzo MA, Fisher M, Lock JP. Hypermagnesemic pseudocoma. Arch Intern Med. 1993;153(9):1130.</ref> | ||
*Intracellular magnesium profoundly blocks several cardiac potassium channels | *Intracellular magnesium profoundly blocks several cardiac potassium channels | ||
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==Clinical Features== | ==Clinical Features== |
Revision as of 10:10, 8 May 2017
Contents
Background
- High >3.5
- Magnesium is an effective calcium channel blocker both extracellularly and intracellularly[1]
- Intracellular magnesium profoundly blocks several cardiac potassium channels
Clinical Features
- Symptoms may be mild nausea and vomiting initially to diaphragmatic paralysis as the Mg concentration increases
Differential Diagnosis
- Renal Failure
- Lithium
- Volume depletion
- Rhabdo
- IV Mg (goal in PET/eclampsia 5-7 mEq/L)
- Massive PO intake (laxative abusers, accidental Epsom salts)
- Magnesium enemas[2]
Evaluation
Mg Level | Signs/Symptoms |
---|---|
2-3 | Nausea |
3-4 | Somnolence |
4-8 | Loss of DTRs, muscle weakness |
8-12 | Respiratory depression |
12-15 | Hypotension, heart block, Cardiac Arrest, death |
Management
- IVF (NS)
- Furosemide 20-40mg IVP
- CaCl 10% 5-10mL IV or Ca gluconate 10% 15-30mL IV over 5min
- Consider HD for Mg > 8 or poor renal function