Hypomagnesemia aminoglycosides

Causes of hypocalcemia include hypoparathyroidism, hypomagnesemia, alcoholism, hyperphosphatemia, blood product infusion (due to chelation by the citrate buffers), chronic renal failure, vitamin D deficiency, acute pancreatitis, alkalosis, and hypoalbuminemia. Medications that cause hypocalcemia include phosphate replacement products, loop diuretics, phenytoin (Dilantin, available as generic), pheno-barbital (available as generic), corticosteroids, aminoglycoside antibiotics, and acetazolamide (available as generic).34,39,42... 

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. 

In children with cystic fibrosis, aminoglycosides can cause hypomagnesemia due to excessive renal loss (81). 

Allergies, alkalosis, hypocalcemia, hypokalemia, hypomagnesemia, hyperuricemia, hypovolemia, ototoxicity (ethacrynate > furosemide) enhanced by aminoglycosides. Loop diuretics may decrease lithium clearance. 

Example compounds causing hypomagnesemia include aminoglycosides, cisplatin, cdclosporin, and some diuretics... 

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). 

Electrolyte balance Aminoglycosides cause fluid, electrolyte, and acid-base disorders by altering renal tubular function in several ways, leading to hypokalemia and acidosis or alkalosis. Stimulation of the calcium-sensing receptor has been reported to cause a Bartter-like syndrome (hypokalemic metabolic alkalosis, hypomagnesemia, hypocalcemia, and normal serum creatinine concentrations). More rarely, a proximal renal tubular acidosis (Fanconi syndrome non-anion gap metabolic acidosis) can develop. The mechanisms have been summarized [4 ]. 

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