Sections View Full Chapter Figures Tables Videos 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] GET ACCESS TO THIS RESOURCE 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 Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessSurgery 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessSurgery Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options