Hypermagnesemia acute

Ali A, Walentik C, Mantych GJ, Sadiq HE, Keenan WJ, Noguchi A. Iatrogenic acute hypermagnesemia after total parenteral nutrition infusion mimicking septic shock syndrome two case reports. Pediatrics 2003 112(1 Pt l) e70-2. 

Cao Z, Bideau R, Valdes R Jr, Eliii RJ. Acute hypermagnesemia and respiratory arrest following infusion of MgS04 for tocolysis. Clin Chim Acta 1999 285(l-2) 191-3. 

Hypomagnesemia is treated initially with oral, intramuscular, or intravenous administration of magnesium salts. Immediate control of the symptoms of acute hypermagnesemia is obtained with doses of intravenous calcium repeated hourly but extreme toxicity may require cardiac support or mechanical ventilation. Calcium gluconate and calcium chloride can also be administered as antidotes. Serum levels are lowered by reducing intake and by normal methods of excretion, with diuretics given to patients with normal renal function. Other accompanying electrolyte imbalances should be treated concurrently, followed by treatment of the condi-tion(s) that lead to the imbalances. 

These agents may be used for the treatment of acute constipation or the prevention of chronic constipation. Magnesium oxide (milk of magnesia) is a commonly used osmotic laxative. It should not be used for prolonged periods in patients with renal insufficiency due to risk of hypermagnesemia. Sorbitol and lactulose are nonabsorbable sugars that can be used to prevent or... 

Hypermagnesemia occurs in acute or chronic renal failure, in hemodialysis, and in women receiving magnesium sulfate for treatment of preeclampsia. The clinical manifestations resemble the effects of curare. At serum Mg + levels of 2.5-5.0 mmol/L, cardiac conduction is affected, and at concentrations above 12.5 mmol/L, cardiac arrest occurs in diastole. Hypomagnesemia can occur in steatorrhea, alcoholism, diabetic ketoacidosis, and many other disorders. Tetany usually occurs at serum Mg " " concentrations below 1 mmol/L. 

Hypermagnesemia is commonly observed in patients with acute or chronic kidney disease. 

Unlike hyperkalemia and hypermagnesemia, acute hyperphosphatemia causes few sudden problems. The major effect is to cause hypocalcemia and tetany if semm phosphate rises too rapidly. Calcium can be deposited in the tissues in hyperphosphatemia. 

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