Answer: Emergent Dialysis
Magnesium has a fairly good therapeutic margin, but hypermagnesemia is a risk in some patients, particularly renal failure. Mild hypermagnesemia may cause weakness, nausea, vomiting, and hypotension, but it can become progressively life-threatening. Following are the ballpark clinical signs/symptoms depending on magnesium level.
- 4.0 mEq/L hyporeflexia
- 5.0 mEq/L Prolonged atrioventricular conduction
- 7.0-10.0 mEq/L - loss of patellar reflex
- 10.0-13.0 mEq/L - respiratory depression and various heart block
- Above 13.0 mEq/L - cardiac arrest/Asystole.
Bansal AD, Negoianu D, Warburton KM. An Unusual yet "Mg"nificent Indication for Hemodialysis. Semin Dial. 2016 May;29(3):247-50. doi: 10.1111/sdi.12479. Epub 2016 Feb 25. PMID: 26915350; PMCID: PMC5492508.