HYPOMAGNESEMIA

Question 1

MANAGEMENT

Answer 1

MODERATE TO SEVERE (SYMPTOMATIC)
Magnesium Sulfate 2 to 5 g diluted in 100 mL NS
ECG Monitoring

ASYMPTOMATIC
magnesium rougier 15 mL PO

Magnesium Oxide 400 mg PO, 1-3 doses daily

INVESTIGATIONS
Lytes
Extended Lytes

MONITOR
Telemetry / ECG Monitoring
Prolonged QT -> Torsades to Pointes -> Cardiac Arrest
Arrythmias: Afib / Aflutter
Seizures
Hypokalemia
Hypocalcemia

Question 2

DOCUMENTATION

Answer 2

CLINICAL FEATURES
Hyperreflexia
Nystagmus
Delirium

ECG
Prolonged PR interval
Prolonged QT interval
Atrial and ventricular ectopy
Predisposition to ventricular tachycardia and torsades de pointes

Question 3

DDX

Answer 3

Drugs: Diuretics, PPI, Alcoholism

Infection: Sepsis

Metabolic: Hypercalcemia, Hypophosphatemia, Metabolic Acidosis; Vomit, Diarrhea; Pancreatitis; Malabsorption; Malnutrition

Renal loss: Diuresis, CTD, RTA