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Correction
- Asymptomatic: IV or oral alcium
- Acute symptomatic: IV 10% calcium gluconate to achieve
serum conc of 7-9 mg/dl
Correction Correction
- enteral and parenteral repletion - phosphate binders (Sucralfate or aluminum containing antacids
- if hypocalcemia coexist: calcium acetate
- Excretion may be aided by saline infusion
- Dialysis for patients with renal failure
MAGNESIUM Kidney is primarily responsible for Mg homeostasis through Rare
Dietary intake regulation by Ca/Mg receptors on renal tubular cells Mg containing antacids and laxatives can produce toxic levels in
approx. 20 meq/d patients with renal failure
1/3 is bound with Causes:
albumin Alterations of intake, renal excretion and pathologic losses Symptoms
- nausea, vomiting, neuromuscular dysfunction, impaired cardiac
Symptoms conduction
- neuromuscular and nervous system hyperactivity - ECG: (same with hyperkalemia); increased PR, wide QRS, high
- hyperactive reflexes, muscle tremors, tetany, positive T
chovsteks and trousseaus sign
- ECG: prolonged QT and PR, ST depression, flat or Correction
inverted P, torsade de pointes, arrhythmia - elimination of exogenous sources, correction of concurrent
volume deficits, correction of acidosis if present
Correction - Acute symptoms: calcium chloride (antagonize CV effects)
- oral repletion - Hemodialysis
- IV repletion
- 102 g of magnesium sulfate administed IV over 15 mins