Hypermagnesemia-Induced Hypotension and Hypoventilation

Abstract

To the Editor. —Clinically significant hypermagnesemia occurs infrequently in patients with normal renal function. 1 A patient is presented who developed hypermagnesemia-induced hypotension and respiratory depression, which was precipitated by the administration of magnesium citrate to a patient with a small-bowel obstruction who had normal renal function. Report of a Case. —A 64-year-old woman was admitted with abdominal pain. She had a history of vitamin D deficiency that was well controlled on 1,25(OH) 2 [calcitriol] vitamin D and calcium carbonate (CaCO 3 ). She discontinued these medicines 2 years prior to admission. On admission ( t = -25 h), she was hypocalcemic, hypomagnesemic, hypokalemic, and had an elevated alkaline phosphatase level. Her serum creatinine level was normal. The patient was treated with calcium, potassium, parenteral magnesium sulfate (MgSO 4 ) (Mg ++ 8.1 mmol by continuous infusion from t = -9.7 h through t = -0.3 h) and oral magnesium citrate (Mg ++ 125 mmol) at t = -23.7