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Published byAlec Haxby Modified over 10 years ago
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Spotlight On Dr. Mohammad El-Tahlawi
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Introduction
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2 nd most abundant intracellular cation. Cofactor > 300 ATP enzymatic reaction. Excitable tissues. * Ca ++ movement. Heart Vascular tone
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Balance
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Adult body 21.. 28 g > 50% bone > 45% muscle 0.7% RBCs 0.3% plasma
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0.3% plasma 1.4 - 2 mEq/L 55 % ionized ( active ) 45 % Non - ionized 33 % Protein bound 12 % chelated
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Urinary Mg. 5 -15 mEq / 24 hr
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Transcellular transport. Intestinal absorption. Renal Excretion. Hormonal Modulation. Body’s “Orphan” ion
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Hypomagnesaemia Mg level <1.5 mEq/L
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Clinical Aspects
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Predisposing Conditions
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Drugs Furosemide 50 % Aminoglycosides 30 % Amphotericin Digitalis 20 % Cisplatin, Cyclosporine
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Diarrhea ( Secretory )
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Chronic Alcoholism
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Diabetes
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Acute MI
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Clinical Manifestations
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Associated Electrolyte Abnormalities Hypokalaemia. Hypocalcemia. Hypophosphatemia. Refractory
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Mg and Stroke Neuroprotective. Reactive Central Nervous System Mg Deficiency.
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Mg and AMI Mg Infusion Prior to In parallel with thrombolytic agent
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Mg and Arrhythmia Atrial Ventricular ECG: prolonged QT, PR intervals
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Mg & & Atherosclerosis
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Mg & & Bronchial asthma
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Diagnosis
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Mg Retention Test. Predisposing Factors. Refractory Electrolyte disor.
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Management
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MgSO 4 1 gm = 8 mEq = 4 mmol
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1 mEq / Kg 1st day Mild Mg Deficiency 0.5 mEq / Kg / day 3 days Oral Mg.
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48 mEq over 3 hrs Moderate Deficiency 40 mEq over next 6 hrs 40 mEq / 12 hrs 5 days
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16 mEq over 2 min. Life - threatening 40 mEq over next 6 hrs. 40 mEq / 12 hrs 5 days.
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Mg and ICU 65% Adult ICU. 30% Neonatal ICU. 10% General hosp. Patients.
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Mg The most underdiagnosed electrolyte abnormality in current medical practice.
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Thank You
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