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Sự thay đổi trong 1 phân phối magiê. Tái phân phối của magiê lưu thông xảy ra do sự thay đổi ngoại bào nội bào, cô lập, hội chứng xương đói, hoặc bằng cách quản lý cấp tính của đường huyết, insulin, hoặc axit amin. | 138 Hypermagnesemia 3. Agents that enhance renal magnesium excretion include alcohol loop and thiazide diuretics amphotericin B aminoglycosides cisplatin and pentamidine. D. Alterations in magnesium distribution 1. Redistribution of circulating magnesium occurs by extracellular to intracellular shifts sequestration hungry bone syndrome or by acute administration of glucose insulin or amino acids. 2. Magnesium depletion can be caused by large quantities of parenteral fluids and pancreatitis-induced sequestration of magnesium. II. Clinical manifestations of hypomagnesemia A. Neuromuscular findings may include positive Chvostek s and Trousseau s signs tremors myoclonic jerks seizures and coma. B. Cardiovascular. Ventricular tachycardia ventricular fibrillation atrial fibrillation multifocal atrial tachycardia ventricular ectopic beats hypertension enhancement of digoxin-induced dysrhythmias and cardiomyopathies. C. ECG changes include ventricular arrhythmias extrasystoles tachycardia and atrial arrhythmias atrial fibrillation supraventricular tachycardia torsades de Pointes . Prolonged PR and QT intervals ST segment depression T-wave inversions wide QRS complexes and tall T-waves may occur. III. Clinical evaluation A. Hypomagnesemia is diagnosed when the serum magnesium is less than 0.7-0.8 mmol L. Symptoms of magnesium deficiency occur when the serum magnesium concentration is less than 0.5 mmol L. A 24-hour urine collection for magnesium is the first step in the evaluation of hypomagnesemia. Hypomagnesia caused by renal magnesium loss is associated with magnesium excretion that exceeds 24 mg day. B. Low urinary magnesium excretion 1 mmol day with concomitant serum hypomagnesemia suggests magnesium deficiency due to decreased intake nonrenal losses or redistribution of magnesium. IV. Treatment of hypomagnesemia A. Asymptomatic magnesium deficiency 1. In hospitalized patients the daily magnesium requirements can be provided through either a balanced diet as oral .
