{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T16:34:57Z","timestamp":1648658097209},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Older patients often have multiple medical issues which predisposes them to complications of polypharmacy and medication interactions. We present a case of an 89-year-old female who presented to the emergency department after a fall. An electrocardiogram (ECG) showed a junctional bradycardia with a ventricular rate of 50 beats per minute (BPM). Her magnesium was 3.5\u00a0mg\/dl (1.7\u20132.3\u00a0mg\/dl). She had recently increased her milk of magnesia use for constipation. Pertinent other medications included verapamil 280\u00a0mg daily. On admission 2 grams of calcium gluconate IV were administered and the verapamil was held. An ECG the next morning showed sinus rhythm with a ventricular rate of 76\u00a0BPM.<\/jats:p>","DOI":"10.1093\/ageing\/afaa114","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T11:07:32Z","timestamp":1590059252000},"page":"1112-1113","source":"Crossref","is-referenced-by-count":1,"title":["Escalating the dose and downgrading the rhythm: the combination of prescribed and non-prescribed medications resulting in an abnormal heart rhythm"],"prefix":"10.1093","volume":"49","author":[{"given":"Hollie","family":"Saunders","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Garland","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jed Colt","family":"Cowdell","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"2020102309311175000_ref1","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1111\/j.1365-2710.2012.01352.x","article-title":"Junctional Bradycardia with verapamil in renal failure\u2014care required even with mild Hyperkalemia","volume":"37","author":"Hegazi","year":"2012","journal-title":"Clinical Pharmacy and Therapeutics"},{"key":"2020102309311175000_ref2","first-page":"509","article-title":"Junctional bradycardia due to cathartic\u2014a rare presentation of hypermagnesaemia in emergency department","volume":"39","author":"Chien-Yu","year":"2008","journal-title":"Resuscitation"},{"key":"2020102309311175000_ref3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.2169\/internalmedicine.45.1482","article-title":"Cathartic-induced fatal hypermagnesemia in the elderly","volume":"45","author":"Onishi","year":"2006","journal-title":"Intern Med"},{"key":"2020102309311175000_ref4","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0736-4679(01)00462-0","article-title":"Hypermagnesemia-induced fatality following Epsom salt gargles","volume":"22","author":"Birrer","year":"2002","journal-title":"J Emerg Med"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/49\/6\/1112\/33993285\/afaa114.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ageing\/article-pdf\/49\/6\/1112\/33993285\/afaa114.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T13:32:43Z","timestamp":1603459963000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/49\/6\/1112\/5874833"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,3]]},"references-count":4,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,8,3]]},"published-print":{"date-parts":[[2020,10,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afaa114","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,8,3]]}}}