HYPERMAGNESEMIA 1. Causes: • Insufficient - TopicsExpress

HYPERMAGNESEMIA 1. Causes: • Insufficient excretion: Renal failure (avoid magnesium-containing laxatives in these patients). • Excess intake: iatrogenic—overaggressive replacement, laxative use (with renal insufficiency), administration during treatment for preeclampsia/eclampsia. 2. Signs (rarely present until Mg > 4 mEq/L): areflexia, lethargy, weakness, paralysis, respiratory failure, hypotension, bradycardia, coma, cardiac arrest. 3. Treatment: • Asymptomatic: hold magnesium supplementation. • Symptomatic: 1 amp calcium gluconate IV over 10 minutes to antagonize Mg. Support ventilation and heart rate if necessary. Definitive therapy requires dialysis.

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