Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Renal insufficiency• Elevated serum magnesium +++ Epidemiology + • Usually occurs in patients with renal disease• Rare in surgical patients +++ Symptoms and Signs + • Lethargy• Weakness• Widened QRS complex• Depressed ST segment• Peaked T waves + • When serum level reaches 6 mEq/L, deep tendon reflexes are lost• Levels > 10 mEq/L can lead to somnolence, coma, and death + • Magnesium should be carefully monitored in patients with renal insufficiency• Serum levels• ECG + • IV isotonic saline to increase renal excretion• Slow IV infusion of calcium• Dialysis may be necessary +++ Medications + • Isotonic saline infusion• Calcium gluconate infusion +++ Treatment Monitoring + • ECG monitoring• Serum magnesium levels +++ Prognosis + • Excellent if treated +++ Prevention + • Regulation of magnesium intake in patients with renal insufficiency +++ References ++Whang R. Clinical disorders of magnesium metabolism. Compr Ther. 1997;23:168. [PubMed: 9113454] ++Onishi S. Yoshino S. Cathartic-induced fatal hypermagnesemia in the elderly. Internal Medicine. 2006, 45(4):207-10. [PubMed: 16543690] Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth