Paulson - Magnesium

Question 1

hypermagnesemia definition

Answer 1

Mg > 2.5

Question 2

hypermagnesemia is rare and usually 2/2

Answer 2

renal failure

Question 3

causes of hypermagnesemia (4)

Answer 3

oral ingestion

Mg enemas

Mg infusion

renal insufficiency

Question 4

what do you see when you see hyperkalemia rt Mg infusion

Answer 4

pregnancy → eclampsia/preeclampsia

Question 5

how does ckd affect magenesium

Answer 5

as ckd worsens → Mg rises

Question 6

2 meds that cause hypermagnesemia

Answer 6

antacids

laxatives

Question 7

when is hypermagnesemia symptomatic

Answer 7

Mg > 4

Question 8

mc sx of hypermagnesemia

Answer 8

neuromuscular toxicity

Question 9

Mg 4-6

Answer 9

nausea

flushing

ha

lethargy

drowsiness

decreased dtr’s

Question 10

Mg 6-10 (6)

Answer 10

somnolence

hypocalcemia

absent dtr’s

hypotn

bradycardia

ekg changes

Question 11

Mg >10

Answer 11

muscle paralysis →

flaccid quadriplegia

apnea

respiratory failure

heart block

cardiac arrest

Question 12

dx for hypomagnesemia (3)

Answer 12

serum. Mg → separate lab

bmp

ekg

Question 13

ekg changes associated w. hypermagnesemia (3)

Answer 13

diminished conduction

widened qrs

prolonged pq

Question 14

tx for hypermagnesemia w. normal renal fxn (2)

Answer 14

stop offending agent

+/- diuretics

Question 15

pharm for hypermagnesemia

Answer 15

IV calcium gluconate

Question 16

tx for hypermagnesemia if severe + renal impairment

Answer 16

hd

Question 17

hypomagnesemia definition

Answer 17

Mg < 1.8

Question 18

mc causes of hypomagnesemia (3)

Answer 18

chronic diuretics → loop and thiazide

chronic diarrhea

chronic ppi

also hypoparathyroidism, etoh

Question 19

hypomagnesemia affects

Answer 19

neuro

cardiovascular

Question 20

neuro sx of hypomagnesemia (3)

Answer 20

tetany → trosseau and chvostek

sz

involuntary movements

Question 21

ekg changes associated w. moderate hypomagnesemia

Answer 21

QRS widening and peaked T waves

Question 22

ekg changes associated w. severe hypomagnesemia (3)

Answer 22

prolonged pr interval

qrs widening

diminished t wave

PACs, PVCs

vfib

Question 23

hypomagnesemia frequently occurs w. what other lyte deficiencies

Answer 23

hypokalemia

hypocalcemia

Question 24

if hypomagnesemia cause not obvious from hx, order (2)

Answer 24

24 hr urine Mg excretion

OR

random urine → fraction excretion

Question 25

urine tests can help differentiate

Answer 25

GI vs renal Mg losses

Question 26

sx of severe hypomagnesemia (3)

Answer 26

tetany arrhythmias sz

Question 27

tx for severe hypomagnesemia

Answer 27

IV Mg sulfate

Question 28

dosing consideration for IV Mg sulfate

Answer 28

renal dosing → CrCl \< 30

Question 29

tx for asymptomatic/mild hypomagnesemia

Answer 29

oral replacement → MgCl or Mg oxide

Question 30

major s.e of MgCl or Mg oxide

Answer 30

diarrhea