Dr.Methaq A.M.

Hussein
MRCP (LONDON),,
FRCP(EDIN.)SCE
endocrine(london),F.I.B.M.S
of medicine Professor

Magnesium deficiency

Magnesium deficiency is a condition in which

the amount of magnesium in the blood is
lower than normal. The medical name of this
condition is hypomagnesemi
Causes
Common causes of low magnesium
include :Alcohol
Burns that affect a large area of the body
Chronic diarrhea
Excessive urination (polyuria), such as in uncontrolled
diabetes and during recovery from acute kidney failure
Hyperaldosteronism (disorder in which the adrenal gland releases
too much of the hormone aldosterone into the blood)
Kidney tubule disorders
Malabsorption syndromes, such as celiac disease and inflammatory bowel
disease Malnutrition
Medicines
including amphotericin, cisplatin, cyclosporine, diuretics, proton pump
inhibitors, and aminoglycoside antibiotics
Pancreatitis (swelling and inflammation of the pancreas)
Excessive sweatin

Symptoms
Clinical features are often due to accompanying hypokalemia and
hypocalcemia and include lethargy, tremor, tetany, seizures, and
arrhythmias
some patients are asymptomatic. Clinical manifestations include anorexia,
nausea, vomiting, lethargy, weakness, personality change, tetany (eg,
positive Trousseau or Chvostek sign or spontaneous carpopedal spasm,
.hyperreflexia), and tremor and muscle fasciculations
 Exams and Tests .
Tests that may be ordered include magnesium test
an electrocardiogram (ECG).A blood test will be
ordered to check your magnesium level. Normal
range is 1.3 to 2.1 mEq/L (0.65 to 1.05
mmol/L). Other blood and urine tests that may be
done include:Calcium blood test Comprehensive
metabolic panelPotassium blood testUrine
magnesium test

TREATMENT
Oral magnesium salts (eg, magnesium gluconate 500 to
1000 mg orally 3 times a day) are given for 3 to 4 days.
Parenteral administration is reserved for patients with severe,
symptomatic hypomagnesemia who cannot tolerate oral drugs.. When
magnesium must be replaced parenterally, a 10% magnesium sulfate
solution (1 g/10 mL) is available for IV use and a 50% solution (1 g/2
mL) is available for IM use. The serum magnesium concentration should
be monitored frequently during magnesium therapy, particularly when
magnesium is given to patients with renal insufficiency or in repeated
parenteral doses..In severe, symptomatic hypomagnesemia 2 to 4 g of
magnesium sulfate IV is given over 5 to 10 minutes. When seizures
persist, the dose may be repeated up to a total of 10 g over the next 6
hours. In patients in whom seizures stop, 10 g in 1 L of 5% D/W
(dextrose in water) can be infused over 24 hours, followed by up to 2.5
g every 12 hours to replace the deficit in total magnesium stores and
prevent further drops in serum magnesium..
Possible ComplicationsUntreated, this
condition can lead to: Cardiac arrest
Respiratory arrest
Death