Pantoprazole
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Hypomagnesaemia: 2 case reports In a case report of 2 women, a two women aged 59 years and 71 years were described, who developed hypomagnesaemia during treatment with pantoprazole [routes and dosages not stated]. Case 1: A 59-year-old woman had a history of hypertension and diabetes mellitus, for which she had been receiving various medications. One month before admission, she was diagnosed with pulmonary tuberculosis and she received unspecified treatment. Then, she developed vomiting and epigastric pain, and she started receiving pantoprazole one month later. Two days after initiating pantoprazole, she requested discharge at-own-risk from hospital. After 3 days, she was again admitted because of epigastric pain and persistent vomiting. On day 1 of admission, she developed an episode of prolonged QTc and narrow-complex tachycardia, and she went into respiratory distress. Therefore, she was intubated and was transferred to the ICU. Her blood reports showed multiple electrolyte abnormalities including hypomagnesaemia, hypophosphataemia, hypokalaemia and hypocalcaemia (7 days after starting pantoprazole). She then received IV treatment including potassium chloride, magnesium sulfate and calcium gluconate. Despite receiving treatment, her calcium, magnesium and potassium levels failed to return to normal. On hospital day 3, she stopped receiving pantoprazole. Thereafter, the serum levels of calcium, magnesium and potassium started to respond to the treatment and slowly returned to normal. Unfortunately, she developed hospital-acquired pneumonia and died after 2 weeks due to septicaemia. Case 2: A 71-year-old woman had a history of bilateral knee osteoarthritis, diabetes mellitus, chronic kidney disease stage V and hypertension. Five months before admission, she was diagnosed with peptic ulcer disease. Hence, she was started on pantoprazole since that admission. On the day of admission, she experienced with bilateral hand numbness and lethargy. Blood reports showed severe hypomagnesaemia and hypocalcaemia (4 months after starting pantoprazole). Therefore, pantoprazole was withheld on day 2 of hospitalisation and was replaced with ranitidine. She was treated with IV calcium and magnesium. After stopping pantoprazole, her serum magnesium and calcium levels slowly returned to near normal levels. On day 6 of hospitalisation, she was discharged on a calcium carbonate supplement. After a month, at a follow up, her blood calcium and magnesium levels were within normal range. Tai YT, et al. The perilous ppi: Proton pump inhibitor as a cause of clinically significant hypomagnesaemia. Journal of the ASEAN Federation of Endocrine Societies 35: 803497455 109-113, No. 1, 20 Apr 2020. Available from: URL: https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/727
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Reactions 22 Aug 2020 No. 1818
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