Satyendra Dhar, MD @DharSaty · 2 years ago
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If unsure, the distinction between gastrointestinal losses and renal losses can be made by measuring the
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If unsure, the distinction between gastrointestinal losses and renal losses can be made by measuring the 24-hour urinary magnesium excretion. In addition, one can calculate the fractional excretion of magnesium (on a random urine specimen) with the following formula where U and P refer to the urine and plasma concentrations of magnesium (Mg) and creatinine (Cr).
FEMg  = [(UMg x PCr) / (PMg x UCr x 0.7)] x 100
If the fractional excretion of magnesium is above 2% in someone with normal renal function, the hypomagnesemia is likely secondary to renal magnesium wasting from drugs such as diuretics, aminoglycosides, or cisplatin.
2 grams of IV magnesium sulfate increased serum levels by a paltry median of 0.2 mg/dL.  Rechecking too soon may give a false sense of security.
If Magnesium level is 1.7 to 2, give 2 grams of MgSO4 IV.
If Magnesium level is 1.3 to 1.7 give 4 grams of MgSO4  IV.
Parenteral (IV or IM): Magnesium Sulfate (MgSO4)
Magnesium Sulfate is 10% elemental (1 gram Magnesium per 100 ml solution)
One gram MgSO4 contains 8.12 meq Magnesium
One ml MgSO4 50% Solution = 4 meq Magnesium
One ml MgSO4 10% Solution = 0.8 meq Magnesium


Satyendra Dhar MD, @DharSaty

#magnesium #hypomagnesemia #torsades
Satyendra Dhar, MD @DharSaty · 2 years ago
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