Magnesium therapy

Schmidbaur, H., Classen, H. G., and Helbig, J. (1990). Aspartic and glutamic acid as ligands to alkali and alkaline-earth metals Structural chemistry as related to magnesium therapy. Angew. Chem., Int. Ed. Engl. 29, 1090-1103. 

CALCIUM CHANNEL BLOCKERS MAGNESIUM (PARENTERAL) Cases of profound muscular weakness when nifedipine is given with parenteral magnesium Both drugs inhibit calcium influx across cell membranes, and magnesium promotes movement of calcium into the sarcoplasmic reticulum this results in muscular paralysis Do not administer calcium channel blockers during parenteral magnesium therapy... 

Hypocalcemia can result from hypoparathyroidism, chronic renaJ failure, vila-niin D deficiency, and hypomagnesemia. Hypomagnesemia occurs mainly in those with alcoholism so severe as to requite hospitaiization. Magnesium deficiency results in a decline in the responsiveness of osteoclasts to FTH, resulting in interruption of the normal process of bone fumover. In this case, hypocalcemia cannot be effectively corrected unless magnesium therapy is used. 

Reduced pseudocholinesterase activity has been described both in pregnancy and with magnesium therapy. As most ester local anesthetics (with the exception of cocaine) are metabolized by this enzyme, caution should be exercised when using ester local anesthetics in pregnancy, especially with the increasing use of magnesium sulfate in this field. 

A 92-year-old woman developed sudden runs of ventricular tachycardia, a few days after she started to take cilostazol because of subacute leg ischemia. She was known to have atrial fibrillation and intraventricular conduction delay. The runs did not respond to empirical magnesium therapy but subsided shortly after withdrawal of cilostazol. 

The repeated demonstration of a magnesium concentration of less than 0.7 mtnol/l in a serum specimen is evidence of marked intracellular depletion and of a clinical condition which may benefit from magnesium therapy. However, intracellular magnesium depletion may exist where the serum magnesium concentration is within the reference range. Research procedures are required to detect these marginal states. These include the use of NMR spectroscopy to detect free. Mg inside cells. 

Ip-Yam C, AlL p E. Abnomal response to suxamethonium in a patient receiving magnesium therapy. Anaesdtesia ( 994) 49,355-6. 

Schuh S, Maklas C, Freedman SB, Flint AC, Zork JJ, Bajaj L, Black KJ, Johnson DW, Boutis K North American practice patterns of intravenous magnesium therapy in severe acute asthma in children. Acad Emerg Med 2010 17(11) 1189-96. 

Sullivan JT, Higgins N, Toledo P, Scavone BM, McCarthy RJ, Wong CA. The effect of intravenous magnesium therapy on the duration of intrathecal fentanyl labor analgesia. Int J Obstet Anesth 2012 21(3) 212-6. 

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