Pediatric Hypermagnesemia Medication

Updated: Aug 16, 2018
  • Author: Alicia Diaz-Thomas, MD, MPH; Chief Editor: Sasigarn A Bowden, MD  more...
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Medication

Medication Summary

Treatment depends on the degree of hypermagnesemia and the presence of symptoms. In patients with mildly increased levels, the source of magnesium may simply be removed. In patients with higher concentrations of magnesium or severe symptoms, other treatments are necessary. Reserve calcium for patients with life-threatening symptoms, such as arrhythmias or severe respiratory depression.

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Intravenous fluids

Class Summary

Dilution of the extracellular magnesium concentration is the rationale behind intravenous use. Fluids are used with diuretics to promote diuresis of magnesium by the kidneys.

0.9% sodium chloride (normal saline)

Isotonic fluid. Restores water and sodium chloride losses.

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Diuretics

Class Summary

These agents increase renal excretion of magnesium.

Furosemide (Lasix)

Increases excretion of water by interfering with chloride-binding cotransport system, which inhibits sodium and chloride reabsorption in the ascending loop of Henle and distal renal tubule. Promotes loss of magnesium. Administer PO dose with food or milk to decrease stomach upset.

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Calcium

Class Summary

Calcium directly antagonizes the effects of magnesium.

Calcium chloride (10% sol)

Moderates nerve and muscle performance by regulating action potential excitation threshold. Dose expressed in calcium chloride, not elemental calcium. 1 g calcium chloride contains 270 mg elemental calcium.

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