Notes
Hypomagnesemia Management
Hypomagnesemia
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Definition
- Hypomagnesemia is defined as serum magnesium levels < 1.9 mg/dL
Symptoms and Signs
- The condition's severity can range from asymptomatic to severe, with possible neuromuscular and cardiovascular implications
Mild Cases (Mg2+ 1-1.8 mg/dL)
- Oral magnesium supplements are recommended
- Dosage 240-1000 mg elemental Mg in divided doses
Severe Cases (Mg2+ < 1.0 mg/dL)
- IV magnesium sulfate supplementation is necessary.
- Initial Dose: 1 - 2 gm MgSO4 over 2 to 15 minutes.
- Follow-Up Infusion: 4 - 8 gm over 12-24 hours.
- Monitoring Check Mg2+ levels every 6-12th hourly, aiming for >1 mg/dL
Treatment Monitoring
- Be vigilant for signs of magnesium toxicity.
- Perform regular renal function tests.
- Continuous cardiac monitoring is recommended during IV magnesium administration.
Additional Management Considerations
- Exercise caution with patients having renal impairment (risk of rebound hypermagnesemia).
- If due to renal losses, use K+ sparing diuretics (amiloride, triamterene).
- Concurrent correction of other electrolyte imbalances (Ca+2 and K+) are crucial.