Amphotericin hypomagnesemia with

Hypomagnesemia is usually associated with disorders of the intestinal tract or kidneys. Drugs (e.g., aminoglycosides, amphotericin B, cyclosporine, diuretics, digitalis, cisplatin) or conditions that interfere with intestinal absorption or increase renal excretion of magnesium can cause hypomagnesemia. 

L A. Nephrotoxicity is the most common and most serious toxicity associated with amphotericin B administration. This is manifested by azotemia (elevated serum blood urea nitrogen and creatinine), and by renal tubular acidosis, which results in the wasting of potassium and magnesium in the urine (leading to hypokalemia and hypomagnesemia, requiring oral or intravenous replacement therapy). Normochromic normocytic anemia is also seen with long-term amphotericin B administration. Elevation of hver enzymes is not associated with the use of amphotericin B. 

Because amisulpride may dose-dependently prolong QTc interval, use with caution in patients who have hypokalemia and/or hypomagnesemia or who are taking drugs that can induce hypokalemia and/or magnesemia (e.g., diuretics, stimulant laxatives. Intravenous amphotericin B, glucocorticoids, tetracosactide)... 

Amphotericin-induced hypomagnesemia may be more profound in patients who develop a divalent cation-losing nephropathy associated with cisplatin (12). 

Hypomagnesemia has been associated with more than 50 drugs, especially those that are nephrotoxic, including cisplatin, aminoglycoside antibiotics, cyclosporine, and amphotericin B. Secondary hypocalcemia and hypokalemia may result with myasthenia and tetany (Swaminathan 2003). 

Renal toxicity is dose-limiting with amphotericin B. Azotemia is commonplace and sometimes is severe enough to warrant dialysis. Decreases in glomerular filtration rate may be reversible, but irreversible damage can occur, presenting as renal tubular acidosis with hypokalemia and hypomagnesemia. The answer is (C). 

Decreased magnesium levels, that is, levels of 1.2 mEq/L (0.64 mmol/L) or less, may be noted in patients with conditions that cause excessive urinary loss of magnesium, including poorly controlled diabetes and alcohol abuse, or in patients using drugs such as loop and thiazide diuretics (e.g., Lasix, Bumex, Edecrin, and hydrochlorothiazide), cisplatin (which is used widely to treat cancer), and the antibiotics gentamicin, amphotericin, and cyclosporine. Hypomagnesemia also can... 

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