Hypermagnesemia: Difference between revisions
Neil.m.young (talk | contribs) No edit summary |
Neil.m.young (talk | contribs) No edit summary |
||
| Line 15: | Line 15: | ||
| 4-8 || Loss of DTRs | | 4-8 || Loss of DTRs | ||
|- | |- | ||
| 8-12 || | | 8-12 || Respiratory depression | ||
|- | |- | ||
| 12-15 || [[Hypotension]], [[heart block]], [[Cardiac Arrest]] | | 12-15 || [[Hypotension]], [[heart block]], [[Cardiac Arrest]] | ||
Revision as of 12:48, 13 June 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
| Mg Level | Signs/Symptoms |
|---|---|
| 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% 5-10mL IV or Ca gluconate 10% 15-30mL IV over 5min
- Consider HD for Mg > 8 or poor renal function