Hypermagnesemia
Revision as of 12:45, 13 June 2015 by Neil.m.young (talk | contribs)
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% 5-10mL IV or Ca gluconate 10% 15-30mL IV over 5min
- Consider HD for Mg > 8 or poor renal function