Morning Report: 3/14/2014

by Jay Khadpe MD • March 14, 2014 • Comments Off

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

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

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.

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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