Hypermagnesemia: Difference between revisions
No edit summary |
No edit summary |
||
| Line 17: | Line 17: | ||
#[[Rhabdo]] | #[[Rhabdo]] | ||
#IV Mg (goal in PET/eclampsia 5-7 mEq/L) | #IV Mg (goal in PET/eclampsia 5-7 mEq/L) | ||
#Massive PO intake (laxative abusers, accidental Epsom salts)<ref>Schelling Fatal hypermagnesemia. JR1. Clin Nephrol. 2000 Jan;53(1):61-5.</ref> | #Massive PO intake (laxative abusers, accidental Epsom salts) | ||
#Magnesium enemas<ref>Schelling Fatal hypermagnesemia. JR1. Clin Nephrol. 2000 Jan;53(1):61-5.</ref> | |||
==Treatment== | ==Treatment== | ||
Revision as of 04:46, 5 April 2015
Background
- High >3.5
- Magnesium is an effective calcium channel blocker both extracellularly and intracellularly[1]
- Intracellular magnesium profoundly blocks several cardiac potassium channels.
Diagnosis
- 2–3 - Nausea
- 3–4 - Somnolence
- 4–8 - Loss of DTRs
- 8–12 - Respiratory depression
- 12–15 - Hypotension, heart block, Cardiac Arrest
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]
Treatment
- IVF (NS)
- Furosemide 20-40mg IVP
- CaCl 10% 5mL IV over 5min
- Consider HD for Mg > 8 or poor renal function