Hypomagnesemia: Difference between revisions

Latest revision as of 22:06, 22 September 2016

Background

Hypokalemia, Hypocalcemia and hypophosphatemia are often also present

Clinical Features

CNS
- Muscle weakness
- Ataxia
- Confusion
- Seizures
- Coma
GI
- Dysphagia
Cardiovascular
Miscellaneous

Differential Diagnosis

Causes of hypomagnesemia

ETOH
Malnutrition
Cirrhosis
Pancreatitis
After DKA
GI loss (especially diarrhea)
Renal wasting
- Furosemide
- Hypophosphatemia
Type 2 diabetes mellitus^[1]

Evaluation

Magnesium level
Also check:
- Chemistry
- Phosphate

Management

Serum level >1.7
- No treatment
Serum level 1.2 - 1.7
- Asymptomatic
  - Oral repletion with magnesium oxide 400mg PO
    - Magnesium oxide 400mg = 2g of MgSO4
- Symptomatic (or no POs)
  - 2g MgSO4 IV over 1 hour
Serum level <1.2
- 4g MgSO4 IV over 2 hours

Disposition

External Links

References

↑ Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? Diabetes. 2016 Jan;65(1):3-13.

Authors:

[1] Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? Diabetes. 2016 Jan;65(1):3-13.

[1]

@@ Line 1: / Line 1: @@
 ==Background==
-Low! Clinical
+*[[Hypokalemia]], [[Hypocalcemia]] and [[hypophosphatemia]] are often also present
-==Diagnosis==
+==Clinical Features==
-#CNS (depression, vertigo, ataxia, seizures, inc DTR, tetany
+*CNS
-#Anemia
+**[[Muscle weakness]]
-#Hypotension
+**[[Ataxia]]
-#Hypothermia
+**[[Confusion]]
-#Dysphagia
+**[[Seizures]]
+**[[Coma]]
+*GI
+**[[Dysphagia]]
+*Cardiovascular
+**[[CHF]]
+**[[Dysrhythmias]]
+**[[Hypotension]]
+*Miscellaneous
+**[[Hypokalemia]]
+**[[Hypocalcemia]]
+**[[Anemia]]
-==DDX==
+==Differential Diagnosis==
-#ETOH
+===Causes of hypomagnesemia===
-#Malnutrition
+*[[ETOH]]
-#Cirrhosis
+*[[Malnutrition]]
-#Pancreatitis
+*[[Cirrhosis]]
-#S/P DKA
+*[[Pancreatitis]]
-#GI loss (esp diarrhea)
+*After [[DKA]]
-#Renal wasting
+*GI loss (especially [[diarrhea]])
-##Furosemide
+*Renal wasting
-##Hypophosphatemia
+**[[Furosemide]]
+**[[Hypophosphatemia]]
+*Type 2 [[diabetes mellitus]]<ref>[https://www.ncbi.nlm.nih.gov/pubmed/26696633 Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? Diabetes. 2016 Jan;65(1):3-13.]</ref>
-==Treatment==
+==Evaluation==
-Repleat 2gm IV over 2hrs (universal)
+*Magnesium level
+*Also check:
+**Chemistry
+**Phosphate
-==Source ==
+==Management==
-/12/06 DONALDSON (adapted from Tintinalli)
+*Serum level >1.7
+**No treatment
+*Serum level 1.2 - 1.7
+**Asymptomatic
+***Oral repletion with magnesium oxide 400mg PO
+****Magnesium oxide 400mg = 2g of [[MgSO4]]
+**Symptomatic (or no POs)
+***2g [[MgSO4]] IV over 1 hour
+*Serum level <1.2
+**4g [[MgSO4]] IV over 2 hours
+==Disposition==
+==See Also==
+*[[Electrolyte Abnormalities (Main)]]
+*[[Magnesium]]
+==External Links==
+==References==
+<references/>
 [[Category:FEN]]