Morning Report: 3/14/2014

Today’s Morning Report is presented by Dr. Berzon!

Magnesium

• Balance is a a function of intake and excretion (360 mg intake)

• GI excretion usually stable

• Kidney is main regulator

• Excretion in loop of Henle mainly passive

• Decreased absorption can be induced by diuretic (alters voltage)

• Co-factor in over 300 enzymes

• Used in asthma and pre-eclampsia

• Helpful in depression, DM, OA, migraines, HTN, PMS, RLS

Causes of Hypo Mag

GI

• decreased intake
• chronic diarrhea
• small bowl surgery
• PPI’s

Renal

• medications (diuretics and nephrotoxins)
• alcohol
• DM
• Hyperclacemia, low K and phos, metabolic acidosis
• AKI recovery
• Familial (Gitelman)

Symptoms of Hypo

(excites Neuromuscular system)

• cramps, tremors, numbness, tingling, arrhythmias
• prolonged QT

Treatment of Hypo

• replete PO or IV Mas Sulfate
• K and Phos as needed

Causes of Hyper Mag

• renal insufficiency
• Infusion
• Oral ingestion/ enema

Symptoms of Hyper Mag

(depresses the Neuromuscular system)

• early: loss of patellar reflexes, flushing
• slurred speech, somnolence
• paralysis of skeletal muscle and apnea
• cardiac arrest

Treatment of Hyper Mag

• A,B,C’s
• cessation
• In acute and severe: IV calcium will reverse neuromuscular and cardiac effects

In renal failure

• fluids and diuretics
• rarely Dialysis

Reference:

Uptodate.com

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• Bio
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Jay Khadpe MD

• Editor in Chief of "The Original Kings of County"
• Assistant Professor of Emergency Medicine
• Assistant Residency Director
• SUNY Downstate / Kings County Hospital

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