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hypermagnesemia
Etiology:
1) uncommon in patients without renal failure
2) excessive magnesium therapy for pre-eclampsia
Clinical manifestations:
1) central nervous system
a) somnolence
b) depression of deep tendon reflexes (DTR)
c) paralysis of peripheral & respiratory muscles
d) coma
2) cardiac
a) hypotension
b) heart block
c) arrhythmias
d) cardiac arrest
Laboratory:
- serum magnesium:
- symptoms emerge when > 5.0-7.2 mg/dL (normal: 1.5-2.4 mg/dL)
Management:
1) discontinue magnesium-containing medications
2) intravenous calcium gluconate antagonizes effects of hypermagnesemia
3) volume expansion with normal saline
4) furosemide to enhance urine Mg+2 excretion
5) dialysis in Mg+2-intoxicated patients with renal insufficiency
Related
calcium gluconate
magnesium (Mg+2) in serum
General
electrolyte disorder
sign/symptom
disorder of magnesium metabolism
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 18, 19.
American College of Physicians, Philadelphia 1998, 2018, 2021
- Van Hook JW.
Endocrine crises. Hypermagnesemia.
Crit Care Clin. 1991 Jan;7(1):215-23. Review.
PMID: 2007216