Hypomagnesemia: Tx questions

[whopper]

basic question, I rarely see this and I need some brushing up.

Pt has hypomagnesemia. What is the best treatment based on the level? AT what point is is alright just to give POs? At what point should you give IV? Any POs preferable over others?

Basic question, but in Psychiatry you got this type of thing once in a blue moon. The other electrolytes I got no problem correcting.

---

Members don't see this ad.

 

[alhkim]

basic question, I rarely see this and I need some brushing up.

Pt has hypomagnesemia. What is the best treatment based on the level? AT what point is is alright just to give POs? At what point should you give IV? Any POs preferable over others?

Basic question, but in Psychiatry you got this type of thing once in a blue moon. The other electrolytes I got no problem correcting.

Let's say you goal Mg is > 2.0, which it is for any pt with cardiac disease. If the Mg is < 1.8, I usually treat with Mag sulfate 2 gms IV; if < 1.5, then 4 gms Mag sulfate. The reason I don't use PO formulations is that PO Mag oxide usually do not bump the Mg very much. If the Mg is inbetween 1.8 and 2.0, Mag oxide 400 mgs PO does the trick. Other people may have different trigger points for when to use PO or IV Mag.

 

[Mumpu]

Mg supplementation is done much simpler in OB/Gyn -- run in IV mag until the DTRs go away. (just teasing! )

 

[pikachu]

I think the rule of thumb is 1 g of mag brings you up 0.1 in the serum. oral Mag oxide gives you lots of diarrhea so I don't often use it. I recently gave 8 (!) g IV to a really malnourished alcoholic.

ps, somewhere an intern is thanking you for not transferring to medicine for treatment of hypomagnesemia.

 

[PickyBicky]

I think the rule of thumb is 1 g of mag brings you up 0.1 in the serum. oral Mag oxide gives you lots of diarrhea so I don't often use it. I recently gave 8 (!) g IV to a really malnourished alcoholic.

ps, somewhere an intern is thanking you for not transferring to medicine for treatment of hypomagnesemia.

For your EtOHic, after you replete with IV Mg to your target serum level, how long would you keep them on PO? They should be significantly total body depleted, despite "normal" serum values, no? This is a problem I have run into often on service.

Also, out of curiousity, what was the K on the pt you had to dump nearly a kilo of Mg into?

Thanks in advance,

-PB