Magnesium sulfate overdose and misuse
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Cardiac arrest and CNS disorders following drug toxicity: case report A 40-year-old woman developed cardiac arrest, seizure and diffuse anoxic injury secondary to magnesium sulfate toxicity following its overdose and misuse to achieve weight loss and relief from constipation. The woman, who had a history of alcohol abuse and gastric bypass, presented with status post cardiac arrest. Prior to presentation, she had drunk a bottle of magnesium salts [epsom salts; exact amount ingested not stated] to lose weight and for constipation (misuse). She had a witnessed collapse, and emergency medical service (EMS) arrived within 5 minutes. She was asystolic, and EMS performed a cardio-pulmonary resuscitation with epinephrine 30 minutes before return of spontaneous circulation was obtained. An arterial blood gas revealed CO2 64.7, bicarbonate 16.4, pH 7.03 and partial pressure of oxygen 96 [units not stated]. On admission, her magnesium level was 25 mg/dL. The woman was administered unspecified IV fluids and calcium. Then, she received haemodialysis with improvement of her magnesium level. She also showed signs of seizure and levetiracetam was therefore administered. She continued to exhibit poor neurological function. An MRI revealed diffuse anoxic injury [times to reactions onsetes not stated]. After discussion with her family, she was provided only comfort measures. Eventually, she died [immediate cause of death not stated]. Leap J, et al. Fatal epsom salt overdose. American Journal of Respiratory and Critical Care Medicine 199: no pagination abstr. A4826, No. 9, May 2019. Available from: 803446265 URL: https://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A4826 [abstract]
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Reactions 18 Jan 2020 No. 1787
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