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Magnesium


Functions
regulates the absorption of calcium
regulates the contractility of heart muscle
relaxes smooth muscles
decreases coagulation and acts as a calcium channel blocker
cofactor for delta 6 desaturase (formation of prostaglandin E-1)
necessary for the action of PTH and 1,25 DHCC in bone
needed by actin and myosin to relax contracted muscles

Requirements
RDA - males - 350 mg qd, females - 280 mg qd

Sources
soybean and buckwheat flour

Interactions
thiazide diuretics increase excretion
calcium competes with magnesium for absorption

Hypomagnesemia
Etiology
low intake, abnormal loss - diarrhea
chronic nephritis, diuretic phase of renal failure
Signs
Neuromuscular irritability
muscle tightness and spasm, hyperreflexia, convulsions, tetany
nerve conduction problems
Cardiovascular changes
tachycardia, hypotension
high blood pressure, cardiomyopathy
fatigue, irritability, weakness, poor nail growth, anxiety
dysmenorrhea, anorexia, insomnia, sugar craving
Rx
Magnesium sulfate IV or IM
Antidote
calcium gluconate

Hypermagnesemia
Etiology
Renal insufficiency, overdose, severe dehydration
overuse of antacids containing Mg (Gelusil)
Signs
diarrhea is the biggest problem
hypotension, Curare-like paralysis, sedation,
decreased respiratory function, cardiac arrythmias
warm sensation in body
Rx
Calcium gluconate IV slowly in peripheral veins (not CVP line)

Therapeutics
Musculoskeletal
muscle cramping, torticollis - reduces spasm
chronic fatigue, fibromyalgia - malate form may be helpful
osteoporosis - required for calcification of bone
Cardiac
acute angina, post MI - reduces spasm of coronary vessels
mitral valve prolapse - same symptoms as Mg deficiency
Respiratory
asthma - relaxes smooth muscle
emphysemia, chronic bronchitis - deficiency is common
Gynecology dysmenorrhea - reduces spasm
premenstrual syndrome - deficiency is common
Obstetrics
eclampsia, toxemia of pregnancy
Gastrointestinal
constipation, GI spasm - relaxes smooth muscle
Endocrine
diabetes mellitus - diabetics are typically deficient
Neurology
migraine - IV Mg can stop a migraine attack
Urology
calcium oxalate stone prevention - increases solubility of oxalate
Misc
lead toxicity




Sources
Marz, 2nd Ed
Smith, NCLEX Review, pgs 229-230

 

 

 

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