{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:26:20Z","timestamp":1791977180556,"version":"4.4.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[1998,3,1]],"date-time":"1998-03-01T00:00:00Z","timestamp":888710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To report a case of severe hypermagnesemia caused by magnesium hydroxide in a woman with normal renal function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 42-year-old Hispanic woman with schizophrenia and bipolar affective disorder was transported from jail to the emergency department with confusion, abdominal pain, vomiting, and constipation. She had been treated in jail with magnesium hydroxide, ordered as milk of magnesia 30 mL po each night and Maalox 30 mL po three times daily. Additional medications included lithium carbonate 300 mg po three times daily, chlorpromazine 150 mg po three times daily, benztropine mesylate 1 mg po twice daily, and docusate sodium 100 mg po each morning. Her temperature was 35.1 \u00b0C, blood pressure 108\/58 mm Hg, heart rate 112 beats\/min, and respiratory rate 24 breaths\/min. She would respond only briefly to voice or painful stimuli. Her abdomen was distended and diffusely tender. Laboratory tests included serum magnesium concentration 9.1 mEq\/L (normal 1.3\u20132), blood urea nitrogen 16 mg\/dL (8\u201322), creatinine 0.9 mg\/dL (0.5\u20131.1), calcium 3.9 mEq\/L (4.2\u20135.2), and lithium 1.0 mEq\/L. A laparotomy was performed, and an adhesive band from a previous oophorectomy was found to be compressing the sigmoid colon. Hypermagnesemia, hypothermia, and hypotension continued in the intensive care unit. Despite successful treatment of the hypermagnesemia with calcium, intravenous fluids, and furosemide, the patient's cardiac rhythm degenerated into fatal, pulseless electrical activity on postoperative day 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>This case of severe hypermagnesemia from magnesium hydroxide ingestion illustrates many of the risk factors for hypermagnesemia in patients with normal renal function. People using magnesium-containing medications for relief of gastrointestinal distress may be at increased risk for hypermagnesemia. A brief review of magnesium physiology, clinical effects, and treatment is provided. Frequent use of the laboratory to identify hypermagnesemia is encouraged because it is often a clinically unexpected finding and responds well to early treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO:<\/jats:title>\n                    <jats:p>Describir el caso de hipermagnesemia severa en una mujer de 42 a\u00f1os con funci\u00f3n renal normal luego de la ingesti\u00f3n de hidr\u00f3xido de magnesio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN DEL CASO:<\/jats:title>\n                    <jats:p>Una paciente de 42 a\u00f1os de edad con historial de esquizofrenia y desorden afectivo bipolar se presenta a sala de emergencia con confusi\u00f3n, dolor abdominal, v\u00f3mito y estre\u00f1imiento. La paciente, que estab a encarcelada, hab\u00eda estado recibiendo hidr\u00f3xido de magnesio ordenado como \u201cMOM 30 mL po qhs y Maalox 30 mL po tid.\u201d Otros medicamentos concurrentes inclu\u00edan carbonato de litio 300 mg po tid, clorpromazina 150 mg po tid, mesilato de benztropina 1 mg po bid, y docusato s\u00f3dico 100 mg po qam. Su temperatura al momento de la visita a sala de emergencia fue 35.1 \u00b0C, presi\u00f3n sangu\u00ednea 108\/58 mm Hg, pulso 112\/min, y frecuencia respiratoria 24\/min. La paciente se despertaba s\u00f3lo brevemente en respuesta a voz o dolor. Su abdomen estaba distendido y difusamente doloroso a la palpaci\u00f3n. Los resultados de las pruebas de laboratorio revelaron un magnesio s\u00e9rico de 9.1 mEq\/L (normal 1.3\u20132). BUN 16 mg\/dL (8\u201322), creatinina 0.9 mg\/dL (0.5\u20131.1), calci 3.9 mEq\/L (4.2\u20135.2) y litio 1.0 mEq\/L. Al realizar una laparotom\u00eda se encontr\u00f3 una banda adhesiva de una ooferectom\u00eda previa que estaba comprimiendo el colon sigmoide. Su estad\u00eda en la unidad de cuidado intensivo se complic\u00f3 debido a hipermagnesemia, hipotermia, e hipotensi\u00f3n. A pesar de tratar exitosamente la hipermagnesemia con calcio, l\u00edquidos intravenosos, y furosemida al segundo d\u00eda post-operatorio su ritmo cardiaco degener\u00f3 en una actividad el\u00e9ctrica sin pulso fatal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSI\u00d3N:<\/jats:title>\n                    <jats:p>Este caso de hipermagnesemia severa luego de ingesti\u00f3n de hidr\u00f3xido de magnesio ilustra muchos de los riesgos de hipermagnesemia severa luego de ingesti\u00f3n de hidr\u00f3xido de magnesio ilustra muchos de los riesgos de hipermagnesemia en pacientes con funci\u00f3n renal normal. Pacientes que utilizan medicamentos que contienen magnesio para el alivio de problemas gastrointestinales pueden estar a mayor riesgo de hipermagnesemia. Se provee un breve repaso de la fisiolog\u00eda de magnesio, efectos cl\u00ednicos, y el tratamiento. Se recomienda el uso frecuente de pruebas de laboratorio para identificar la hipermagnesemia debido a que frecuentemente es un hallazgo cl\u00ednico inesperado y responde bien al tratamiento temprano.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF:<\/jats:title>\n                    <jats:p>D\u00e9crire un cas d'hypermagn\u00e9s\u00e9mie s\u00e9v\u00e8re suite \u00e0 l'ingestion d'hydroxyde de magn\u00e9sium chez une femme de 42 ans ayant une fonction r\u00e9nale normale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00c9SUM\u00c9 DU CAS:<\/jats:title>\n                    <jats:p>Une femme de 42 ans, souffrant de schizophr\u00e9nie et d'un trouble affectif bipolaire, a \u00e9t\u00e9 amen\u00e9e \u00e0 l'urbence d'un h\u00f4pital et pr\u00e9sentait de la confusion, des douleurs abdominales, des vomissements, et de la constipation. Elle a re\u00e7u, en prison, de l'hydroxyde de magn\u00e9sium \u00e0 raison de 30 mL 4 fois par jour. Elle recevait aussi du carbonate de lithium \u00e0 raison de 300 mg 3 fois par jour, du chlorpromazine \u00e0 raison de 150 mg 3 fois par jour, du m\u00e9sylate de benzotropine \u00e0 raison de 1 mg 2 fois par jour, et finalement du docusate de sodium 100 mg le matin. Sa temp\u00e9rature corporelle \u00e9tait de 35.1 \u00b0C, sa tension art\u00e9rielle 108\/58 mm Hg, son pouls 112 par minute et son rythme respiratoire 24 par minute. La patiente, \u00e0 l'urgence, s'\u00e9veillait pour de courtes p\u00e9riodes \u00e0 cause de la douleur ou lorsqu'on lui parlait. Son abdomen \u00e9tait distendu et tendre. Les tests de laboratoire ont donn\u00e9e les r\u00e9sultats suivants: magn\u00e9s\u00e9mie 9.1 mEq\/L (n = 1.3\u20132), azote ur\u00e9ique 16 mg\/dL (8\u201322), cr\u00e9atinin\u00e9mie 0.9 mg\/dL (0.5\u20131.1), calc\u00e9mie 3.9 mEq\/L (4.2\u20135.2), et lithi\u00e9mie 1.0 mEq\/L. Lors de la laparotomie, une bande adh\u00e9sive d'une oophorectomie ant\u00e9rieure a \u00e9t\u00e9 trouv\u00e9e et comprimait le c\u00f4lon sigmo\u00efde. Aux soins intensifs, elle a pr\u00e9sent\u00e9 de l'hypermagn\u00e9s\u00e9mie, de l'hypothermie et de l'hypotension. Malgr\u00e9 un traitement r\u00e9ussi de l'hypermagn\u00e9s\u00e9mie avec du calcium, des liquides intraveineux et du furos\u00e9mide, son rythme cardiaque a d\u00e9g\u00e9ner\u00e9 jusqu'\u00e0 l'absence d'activit\u00e9 \u00e9lectrique lors du deuxi\u00e8me jour post-op\u00e9ratoire, ce qui a caus\u00e9 la mort de cette femme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Ce cas d'hypermagn\u00e9s\u00e9mie s\u00e9v\u00e8re, suite \u00e0 l'ingestion d'hydroxyde de magn\u00e9sium, montre plusieurs des facteurs de risque d'hypermagn\u00e9s\u00e9mie chez des patients pr\u00e9sentant une fonction r\u00e9nale normale. Les personnes qui utilisent des m\u00e9dicaments contenant du magn\u00e9sium pour le soulagement de troubles gastrointestinaux peuvent \u00eatre plus \u00e0 risque de d\u00e9velopper de l'hypermagn\u00e9s\u00e9mie. Une br\u00e8ve revue de la physiologie du magn\u00e9sium, de ses effets cliniques et du traitement est faite. L'utilisation fr\u00e9quente de tests de laboratoire pour diagnostiquer l'hypermagn\u00e9s\u00e9mie est encourag\u00e9e, car cette situation est souvent non pr\u00e9vue, mais r\u00e9pond bien au traitement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.17284","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"312-315","source":"Crossref","is-referenced-by-count":29,"title":["Antacid-Induced Hypermagnesemia in a Patient with Normal Renal Function and Bowel Obstruction"],"prefix":"10.1177","volume":"32","author":[{"given":"Steven A","family":"McLaughlin","sequence":"first","affiliation":[{"name":"Steven A McLaughlin MD, Senior Resident, Department of Emergency Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick E","family":"McKinney","sequence":"additional","affiliation":[{"name":"Patrick E McKinney MD, Assistant Professor, Department of Emergency Medicine and College of Pharmacy, Medical Director, New Mexico Poison Center, University of New Mexico Health Sciences Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1998,3,1]]},"reference":[{"key":"bibr1-aph.17284","first-page":"56","volume":"139","author":"Grittle KG","year":"1995","journal-title":"Drug Topics"},{"key":"bibr2-aph.17284","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1997.tb04501.x"},{"key":"bibr3-aph.17284","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.4.8.718"},{"key":"bibr4-aph.17284","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03440220087036"},{"key":"bibr5-aph.17284","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1988.00380110065013"},{"key":"bibr6-aph.17284","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(81)80461-1"},{"key":"bibr7-aph.17284","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1994.74.2.305"},{"key":"bibr8-aph.17284","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1983.93"},{"key":"bibr9-aph.17284","first-page":"274","volume":"29","author":"Mordes JP","year":"1977","journal-title":"Pharmacol Rev"},{"key":"bibr10-aph.17284","doi-asserted-by":"publisher","DOI":"10.3109\/15563658808995397"},{"key":"bibr11-aph.17284","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470170062022"},{"key":"bibr12-aph.17284","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(86)80870-8"},{"key":"bibr13-aph.17284","first-page":"208","volume":"148","author":"Smilkstein MJ","year":"1988","journal-title":"West J Med"},{"key":"bibr14-aph.17284","doi-asserted-by":"publisher","DOI":"10.3109\/15563659609013838"},{"key":"bibr15-aph.17284","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(86)80871-X"},{"key":"bibr16-aph.17284","doi-asserted-by":"publisher","DOI":"10.1159\/000168469"},{"key":"bibr17-aph.17284","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1981.00340050115027"},{"key":"bibr18-aph.17284","doi-asserted-by":"publisher","DOI":"10.1007\/BF02087570"},{"key":"bibr19-aph.17284","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.5.746-a"},{"key":"bibr20-aph.17284","doi-asserted-by":"publisher","DOI":"10.1530\/acta.0.0880619"},{"key":"bibr21-aph.17284","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8627(20)30317-5"},{"key":"bibr22-aph.17284","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0704(18)30333-6"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.17284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.17284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:07:08Z","timestamp":1777374428000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.17284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,3]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1998,3]]}},"alternative-id":["10.1345\/aph.17284"],"URL":"https:\/\/doi.org\/10.1345\/aph.17284","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,3]]}}}