HYPOMAGNESEMIA (electrolyte imbalance)
HYPOMAGNESEMIA It is an electrolyte disturbance in which there is a low level of magnesium normal level - 1.3 -2.1 mEq/L CAUSES: diarrohea, alcoholics Thiazides - inhibits TRPM6(transporter) which causes magnesium reabsorption Amphotericin B Aminoglycosides Renal wasting: Gitelman syndrome PATHOPHYSIOLOGY: Decrease magnesium ￫ relaxation of blood vessel Decrease magnesium ￫ inhibit PTH release ￫ decrease calcium and increase neuromuscular excitability CLINICAL FEATURES: Muscle cramps HTN, HR↑, arrhythmia(Torsades de pointes) Tremors/nystagmus/athetosis WORK UP: Serum magnesium urine magnesium ECG: prolonged QT - Torsades de pointes TREATMENT: IM /IV MgSO4 / Mg oxide /watch DTRs