Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

Hypermagnesemia Hypernatremia 751

■Magnesium level >7 mEq per liter

➣Lethargy

■Magnesium level 5 to 10 mEq per liter

➣Hypotension and prolongation of the PR and QT intervals as well

as QRS duration.

■Magnesium level >10 mEq per liter

➣Paralysis of voluntary muscles and respiratory failure

■Magnesium level >15 mEq per liter

➣Complete heart block or asystole

tests

n/a

differential diagnosis

n/a

management

n/a

specific therapy

■Calcium ion is a direct antagonist of magnesium and should be

given to patients who are seriously ill with magnesium intoxication.

Hemodialysis may be required following cessation of magnesium

therapy.

follow-up

n/a

complications and prognosis

n/a

Hypernatremia......................................

CHIRAG PARIKH, MD, PhD and TOMAS BERL, MD

history & physical

■Polyuria, polydipsia

■Vomiting, diarrhea

■Drugs – loop diuretics

Signs & Symptoms

■Volume status: Important guide to diagnosis and treatment

➣Edema, orthostasis, skin turgor and axillary sweat