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Samenvatting Magnesium
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Hoofdstuk magnesium samenvatting van het boek: Marino's the ICU book
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MagnesiumBasics:
gemiddelde mens heeft 24 gram magnesium; waarvan meer dan de helft in bot zit.
<1% zit in plasma.
Serum magnesium: beter dan plasma; in plasma wordt citraat gebruikt dat magnesium bindt.
Geioniseerd magnesium:
67% van het magnesium in plasma is in de geioniseerde vorm(actief). 33% gebonden aan plasma
proteinen. Of gebonden aan andere anionsen zoals fosfaat en sulfaat.
Bij Mg tekort zal er bijna geen Mg in urine zitten. in urine is effect veel sneller te zien dan in plasma.
Mg deficientie:
in 65% van de patienten op de IC depletie hoeft niet zih te vertonen als hypomagnesiemie; vaak
ondergediagnosticeerd.
uiitlokkende factoren:
Serum Mg zegt weinig over totale Mg poel.
Volgende aandoeningen gaan vaak gepaard met magnesium depletie:
Diuretica:
leading cause. Remming van natrium gaat ook gepaard met remming van reabsorptie van Mg.
( vooral lisdiuretica) Mg depletie niet bij kalium sparende middelen.
Antibiotica:
aminoglycosides, amfoticerine en pentamidine. Aminoglycosides blokkeren Mg reabsorptie in de
stijgende lis van Henle.
Andere medicatie:
Lang gebruik van PPI’s ( twee weken – 13 jaar) verminderde opname in GI.
digitalis, epinephrine( beide Mg shift in cellen) en chemotherapeutica( cisplatina en cyclosporine
renale excretie)
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