1/19/2024 0 Comments Mag sulfate antidote![]() ![]() Renal excretion is an important cause of Mg loss in ICU patients. Discontinuation of PPI use will resultsin quick normalization of serum Mg levels (Mackay and Bladon, 2010 William and Danziger, 2016). Oral Mg is not effective in PPI's induced hypomagnesaemia. PPIs affect intestinal epithelial cell locally. Intravenous Mg supplementation rapidly increases serum Mg level following long-term use of PPIs and subsequent hypomagnesaemia. The mechanism of this action is an increase in the intestinal lumen PH that proceeds to the reduction of TRPM 6/7 channel affinity for Mg (Thongon and Krishnamra, 2011 William et al., 2014). Long-term use of Proton Pump Inhibitors (PPIs) has also been reported to block intestinal absorption of Mg. The most common gastrointestinal (GI) diseases with Mg loss include intestinal malabsorption syndromes, inadequate Mg intake, re-feeding syndrome, chronic diarrhea, short bowel syndrome, fistulae in the intestinal and biliary system, and acute pancreatitis (Booth et al., 1963 Edmondson et al., 1952 Gordon, 1963 Hall and Joffe, 1973 Martin et al., 2009). Noronha and Matuschak in 2009 described major causes of Mg deficiency in ICU patient as: (1) reduction of intestinal absorption of Mg, (2) increased loss of Mgbyrenal route, and (3) compartmental redistribution (Noronha and Matuschak, 2002). Hypomagnesaemia is correlated with poor prognosis and high mortality rate in critically ill patients (Dabbagh et al., 2006). Around 90 % of ICU patients under surgery and 65 % of ICU patients under drug therapy commonly experience hypomagnesaemia (Koch et al., 2002). ![]() One of the key reasons for the wide use of Mg in critical care is the high prevalence of hypomagnesaemia in ICU patients (Noronha and Matuschak, 2002 Tong and Rude, 2005). ![]() Other physiological roles of Mg include: (1) establishing the electrical potential across cell membranes (2) involvement in intermediary metabolism (3) involvement in protein and nucleic acid synthesis (4) exerting depressant effect at the synapse as Mg affects channels on the cardiac and smooth muscles (5) cell cycle regulation (6) mitochondrial functions control (7) maintaining stability of cell membranes, and (8) supporting cytoskeletal integrity (Aikawa, 1980 Dubé and Granry, 2003 Fawcett et al., 1999 Golf et al., 1993 Gordon, 1963 Mubagwa et al., 2007 Nadler and Rude, 1995 Simpson and Knox, 2004 Volpe and Vezu, 1993 Wacker and Parisi, 1968 White and Hartzell, 1989). Magnesium has analgesic properties that are due to N-methyl-D-aspartate (NMDA) receptor blocking action (Akhtar et al., 2011). A defect in any part of the transcellular transports may lead to different diseases such as pre-eclampsia, Parkinson's disease, atrial fibrillation and anoxic brain injury (Kolte et al., 2014). Magnesium deficiency induces a systemic stress to respond during activation of neuroendocrine pathways (Mazur et al., 2007) it has been implicated in the pathophysiology of several diseases and reported to be related to increased mortality in ICU patients (Zafar et al., 2014). Influx and efflux of Mg plays an important role in different transcellular transports (Kolte et al., 2014). Calcium metabolism and transportation has crucial roles in cardiac function, muscular contraction, blood pressure regulation and neuronal activity (Akhtar et al., 2011 Noronha and Matuschak, 2002). Magnesium is a calcium antagonist that acts via regulating intracellular calcium availability (Romani, 2011). Mg activates a lot of enzymatic systems that are essentially necessary in the metabolism of energy. Also, Mg regulates glycolysis-related enzymes (Fawcett et al., 1999). ![]() This element is particularly involved in the storage and transfer of the energy (Noronha and Matuschak, 2002 Reinhart, 1988). Magnesium is an essential co-factor for the enzymatic reactions (Aikawa, 1980). Magnesium is a vital element that is directly or indirectly involved in the physiological processes (Aikawa, 1980). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |