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Lethal iatrogenic hypermagnesemia.

Maria Carmina Garcia1, Ryland P Byrd, Thomas M Roy

  • 1Division of Pulmonary Medicine and Critical Care, Quillen VAMC, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, USA.

Tennessee Medicine : Journal of the Tennessee Medical Association
|August 15, 2002
PubMed
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Magnesium is a safe and effective treatment for various conditions, including preeclampsia and asthma. However, caution is advised in patients with kidney dysfunction or slow intestinal motility to prevent magnesium toxicity.

Area of Science:

  • Pharmacology
  • Nephrology
  • Gastroenterology

Background:

  • Magnesium administration is a recognized therapeutic strategy for conditions like preeclampsia, ischemic heart disease, cardiac arrhythmia, and asthma.
  • It also serves as a cathartic agent for constipation, with a generally favorable safety profile.

Observation:

  • Magnesium is primarily excreted via the kidneys, leading to the expectation of elevated levels mainly in patients with renal impairment.
  • Emerging evidence indicates that factors beyond renal function, such as intestinal hypomotility and chronic constipation, can influence magnesium levels.

Findings:

  • While renal dysfunction is the primary concern for magnesium accumulation, impaired intestinal motility may also contribute to toxicity.
  • These findings highlight the need for a comprehensive assessment of patients before magnesium therapy.

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Implications:

  • Clinicians should consider gastrointestinal factors alongside renal function when prescribing magnesium.
  • This broader perspective can help mitigate the risk of adverse events and ensure patient safety.