Hypomagnesiemia
Contents:
Description:
Hypomagnesiemia — decrease in concentration of magnesium of serum less than 1 ¼Ø¬ó/l.
Hypomagnesiemia symptoms:
The muscular twitchings, tremor and muscular weakness caused by direct influence of magnesium on neuromuscular transmission and reduction of muscles, and also gipokaltsiyemichesky effect of a hypomagnesiemia. The heavy chronic hypomagnesiemia leads to decrease in secretion of PTG and to deterioration in the answer of a bone tissue to PTG. Both of these processes involve a hypocalcemia. The hypomagnesiemia causes also disturbance of a renal reabsorption of potassium that leads to a hypopotassemia. Thus, at patients with a hypomagnesiemia all clinical signs of a hypocalcemia and a hypopotassemia can be observed.
Hypomagnesiemia reasons:
Extrarenal reasons:
- Deficit in food and losses through a GIT (inadequate consumption with food (for example after long starvation, after operations), absorption disturbance (a sprue, chronic abuse of purgatives).
- Redistribution of magnesium in an organism (acute consumption of magnesium cells at alcoholic abstinence, at treatment by insulin, at a respiratory alkalosis; bystry accumulation of magnesium and calcium in bones with the subsequent hypomagnesiemia when strengthening bone formation after a parathyroidectomy concerning a heavy parathyroid osteodystrophy).
Renal reasons:
- Primary canalicular disturbances (Bartter's syndrome, renal canalicular acidosis, postoperative diuresis; after renal transplantation)
- The medicinal caused canalicular losses (diuretic means (for example, thiazide diuretics, furosemide, Acidum etacrynicum); Cisplatinum (even in small doses), gentamycin (nephrotoxic action) - Hormonal the caused canalicular losses (at a hyper aldosteronism, a hypoparathyrosis
- The canalicular losses of magnesium caused by ions or ingredients of food (at a hypercalcemia - calcium and magnesium compete for transport in the ascending knee of a loop of Henle); at a hypophosphatemia and/or an alcoholic poisoning (decrease in a renal reabsorption of magnesium).
Treatment of the Hypomagnesiemia:
At most of patients shortage of magnesium can be filled by normal food.
At the expressed hypomagnesiemia (for example, <1 мЭкв/л или 1,2 мг%) или при её клинических проявлениях (обычно при дефиците магния 1–2 мЭкв/кг или 12–24 мг/кг) назначают магния сульфат (при нормальной функциональной активности почек) в/м или в/в (1 г MgSO4´7H2O содержит 8,1 мЭкв или 97,56 мг элементарного магния). Обычно половину общей дозы (вдвое превышающей дефицит) вводят в течение первых 24 ч, остальное количество — в течение последующих 4 дней при систематическом контроле содержания магния в сыворотке.
At medical emergencies (for example, at the spasms caused by a hypomagnesiemia) — magnesium sulfate in a dose of 2-4 g (in the form of 10% of solution in 20–30 ml of 5% of solution of a dextrose) in/in within 5–15 min. In the absence of effect of an injection repeat before achievement of the general dose 10 g during 6 h. At achievement of effect — intravenous infusion of magnesium of sulfate in a dose of 10 g in 500–1 000 ml of 5% of solution of a dextrose during 24 h, then in a dose of 2,5 g each 12 h before normalization of content of magnesium in serum. At the expressed deficit of magnesium (<1 мЭкв/л), но более слабых клинических проявлениях магния сульфат в можно ввести в/в в 5% р-ре декстрозы со скоростью 1 г/ч в течение 10 ч.
