2. Spotlight On Dr. Mohammad El-Tahlawi

3. Introduction

4. 2 nd most abundant intracellular cation. Cofactor > 300 ATP enzymatic reaction. Excitable tissues. * Ca ++ movement.  Heart  Vascular tone

5. Balance

6. Adult body 21.. 28 g  > 50% bone  > 45% muscle  0.7% RBCs  0.3% plasma

7. 0.3% plasma 1.4 - 2 mEq/L 55 % ionized ( active ) 45 % Non - ionized 33 % Protein bound 12 % chelated

8. Urinary Mg. 5 -15 mEq / 24 hr

9. Transcellular transport.  Intestinal absorption.  Renal Excretion. Hormonal Modulation.  Body’s “Orphan” ion

10. Hypomagnesaemia Mg level <1.5 mEq/L

11. Clinical Aspects

12. Predisposing Conditions

13. Drugs  Furosemide 50 %  Aminoglycosides 30 %  Amphotericin  Digitalis 20 %  Cisplatin, Cyclosporine

14. Diarrhea ( Secretory )

15. Chronic Alcoholism

16. Diabetes

17. Acute MI

18. Clinical Manifestations

19. Associated Electrolyte Abnormalities  Hypokalaemia.  Hypocalcemia.  Hypophosphatemia. Refractory

20. Mg and Stroke  Neuroprotective.  Reactive Central Nervous System Mg Deficiency.

21. Mg and AMI Mg Infusion  Prior to  In parallel with thrombolytic agent

22. Mg and Arrhythmia Atrial Ventricular ECG: prolonged QT, PR intervals

23. Mg & & Atherosclerosis

24. Mg & & Bronchial asthma

25. Diagnosis

26.  Mg Retention Test.  Predisposing Factors.  Refractory Electrolyte disor.

27. Management

28. MgSO 4 1 gm = 8 mEq = 4 mmol

29.  1 mEq / Kg 1st day Mild Mg Deficiency  0.5 mEq / Kg / day 3 days  Oral Mg.

30.  48 mEq over 3 hrs Moderate Deficiency  40 mEq over next 6 hrs  40 mEq / 12 hrs 5 days

31.  16 mEq over 2 min. Life - threatening  40 mEq over next 6 hrs.  40 mEq / 12 hrs 5 days.

32. Mg and ICU  65% Adult ICU.  30% Neonatal ICU.  10% General hosp. Patients.

33. Mg The most underdiagnosed electrolyte abnormality in current medical practice.

34. Thank You