HYPERMAGNESEMIA

Question 1

MANAGEMENT

Answer 1

CARDIAC / RESPIRATORY SYMPTOMS
2 g of Calcium Gluconate OR 1 g of Calcium Chloride IV over 5-10 min

Stop all magnesium administration

Oliguric: emergent dialysis

Not Oliguric / No renal failure: IV fluids followed by 40 to 80 mg IV Furosemide

NO CARDIAC / RESPIRATORY SYMPTOMS
Stop all magnesium

IV fluids if no renal failure

+/-40 to 80 mg IV Furosemide

MONITOR
Respiratory Arrest

Heart block -> cardiac arrest

Question 2

DOCUMENTATION

Answer 2

CLINICAL FEATURES
Hyporeflexia
Muscle Weakness
Bradycardia

ECG
Wide QRS
Peaked T Waves

Question 3

DDX

Answer 3

Renal Failure
Exogenous: infusion, antacids, laxatives
Cellular lysis