- Differential Diagnosis:
- Malabsorption, Steatorrhea, Diarrhea, Laxitive, ETOH/withdrawl, Alcoholism and Cirrhosis, Hyperthyroidism, Aldosteronism, Diuretics,
- RTA, Acute Pancreatitis Hyperparathyroidism, Hyperalimentation, NG suctioning, Chronic Dialysis, RTA, Hungry Bone syndrome,
- Hypophosphatemia, Intracellular shifts w/ respiratory acidosis or metabolic acidosis;
- Meds (Cis Platinum, Amphotericin B, Aminoglycosides Cisplatin, Ifosphamide, Insulin, Diuretics;
- Note that hypoMg may cause hypoK and hypoCa
- Signs and Symptoms:
- paresthesia's, hyperreflexia, muscle spasm, & tetany;
- may cause chondrocalcinosis
- Prophylaxis or Asymptomatic: ( < 1.4)
- Mg Oxide 250 mg tabs contains 12.5 mEq (3 to 8 tabs/day to prevent HypoMg)
- Mg Sulfate: (50% sol. w/ 8.1 mEq per gm)
- prophylactic dose: 4-12 gm/day given IM/IV in D5W;
- Symptomatic HypoMg: ( < 1.4)
- w/ siezures, eclampsia, or arrhythmia's, aggressive Rx is indicated;
- Mg Sulfate: 3 gm in 30 ml D5W IV over 5 min;
- if needed dose may be repeated upto 10 gm in 6 hrs;
- w/ less severe symtoms: 6 gm IV over 3 hrs, then 3 gm q12 hrs;
- in patients with an arrhythmai but no symptoms consider 2 gm IV;
- Misc:
- if renal function is normal, as much as 2 mEq/kg body wt. of magnesium can be administered in one day in the face of severe depletion;
- Mg sulfate (50% solution contains approx 4 mEq of Mg/ml) given IV;
- try 80 mEq of Mg sulfate (20 ml of 50% solution) to 1 liter over 4-6 hr;
- if patient is not symptomatic, the infusion should be given over a longer period of time