Hospital Pharmacy - February 2020 - 67
67
Doshi et al
Figure 2. Percent days in therapeutic range.
Table 2. Incidence of Hypomagnesemia and Hypermagnesemia.
Mean percent days hypomagnesemic, (SD)
Mean percent days hypermagnesemic, (SD)
Short infusion (>0.5 g/h)
Prolonged infusion (0.5 g/h)
P value
0.58 (2.83)
0.74 (3.3)
0.37 (2.48)
0.32 (2.13)
.71
.47
infusion group compared to one out of 45 patients (2.2%) in
the prolonged infusion group. The two patients in the short
infusion group were hypomagnesemic for two out of 21 days
and one out of 6 days respectively. The one patient in the in
the prolonged infusion group was hypomagnesemic for one
out of 6 days from first dose of IV magnesium. With regard
to hypermagnesemia, three out of 45 patients (6.6%) in the
short infusion group were hypermagnesemic (> 2.7 g/dL).
One of these 3 patients was hypermagnesemic for 2 days
whereas two patients were hypermagnesemic for one day.
One out of 45 patients (2.2%) in the prolonged infusion
group was hypermagnesemic for one day (Table 2).
For safety analysis assessing hypotension, five patients
(11%) in the short infusion group had at least one episode of
hypotension compared to none (0%) in the prolonged infusion
group (P = 0.06). One patient had 3 episodes of hypotension,
the first episode was during the 3rd infusion of magnesium
given at a rate of 2 g/h, the 2nd episode was during 4th infusion of magnesium at a rate of 2 g/h, and the 3rd episode was
during 9th infusion (total 8 g) of magnesium at a rate of 2 g/h.
The four other patients had one episode of hypotension, where
three out of the four patients received magnesium at a rate of
2 g/h and one received it at 1 g/h. Notably, review of medical
records did not report an intervention for hypotension in the
instances and two of these patients were hypotensive prior to
and/or after magnesium infusion time.
Discussion
As of this time, no published studies can be found in which
short infusion rates have been compared to prolonged infusion rates for clinical outcomes in hospitalized medicine
patients. However, studies done in the hematopoietic stem
cell transplant (HCT) population have revealed no difference in number of days IV magnesium replacement was
needed between HCT patients receiving short infusion
rates versus prolonged infusion or in grams of magnesium
replaced.6,7 Our report represents the first adequately powered study to compare infusions rates of IV magnesium in
the general medicine patient population, finding no difference in the number of days requiring magnesium replacement out of the magnesium length of stay. Furthermore,
results here in showed no difference in percent of days
therapeutic levels were maintained in the optimal (1.4-2.7)
Hospital Pharmacy - February 2020
Table of Contents for the Digital Edition of Hospital Pharmacy - February 2020
TOC/Verso
CBD: Considerations for Use Within the Health System
Early Acute Ischemic Stroke Management for Pharmacists
Impact of the Sequence of Norepinephrine and Vasopressin Discontinuation in Patients Recovering From Septic Shock
Evaluation of a Long-Acting Opioid Restriction Policy: Does Restriction Reduce the Need for Naloxone Reversal?
Off-label Medications Use in the Eastern Province of Saudi Arabia: The Views of General Practitioners, Pediatricians, and Other Specialists
Piperacillin-Tazobactam Versus Carbapenems for the Treatment of Nonbacteremic Urinary Tract Infections due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae
Factors Associated With Increased Hospital Length of Stay in Peritoneal Dialysis Patients With Peritonitis: A Need for Antimicrobial Stewardship?
The Clinical and Financial Impact of a Pharmacist-Driven Penicillin Skin Testing Program on Antimicrobial Stewardship Practices
Prolonged Versus Short Infusion Rates of IV Magnesium in Hospitalized General Medicine Patients with Hypomagnesemia
Ischemic Stroke Symptoms After Warfarin Reversal With 4-Factor Prothrombin Complex Concentrate Case Report
Hospital Pharmacy - February 2020 - TOC/Verso
Hospital Pharmacy - February 2020 - Cover2
Hospital Pharmacy - February 2020 - 1
Hospital Pharmacy - February 2020 - 2
Hospital Pharmacy - February 2020 - 3
Hospital Pharmacy - February 2020 - 4
Hospital Pharmacy - February 2020 - 5
Hospital Pharmacy - February 2020 - 6
Hospital Pharmacy - February 2020 - 7
Hospital Pharmacy - February 2020 - 8
Hospital Pharmacy - February 2020 - CBD: Considerations for Use Within the Health System
Hospital Pharmacy - February 2020 - 10
Hospital Pharmacy - February 2020 - 11
Hospital Pharmacy - February 2020 - Early Acute Ischemic Stroke Management for Pharmacists
Hospital Pharmacy - February 2020 - 13
Hospital Pharmacy - February 2020 - 14
Hospital Pharmacy - February 2020 - 15
Hospital Pharmacy - February 2020 - 16
Hospital Pharmacy - February 2020 - 17
Hospital Pharmacy - February 2020 - 18
Hospital Pharmacy - February 2020 - 19
Hospital Pharmacy - February 2020 - 20
Hospital Pharmacy - February 2020 - 21
Hospital Pharmacy - February 2020 - 22
Hospital Pharmacy - February 2020 - 23
Hospital Pharmacy - February 2020 - 24
Hospital Pharmacy - February 2020 - 25
Hospital Pharmacy - February 2020 - Impact of the Sequence of Norepinephrine and Vasopressin Discontinuation in Patients Recovering From Septic Shock
Hospital Pharmacy - February 2020 - 27
Hospital Pharmacy - February 2020 - 28
Hospital Pharmacy - February 2020 - 29
Hospital Pharmacy - February 2020 - 30
Hospital Pharmacy - February 2020 - 31
Hospital Pharmacy - February 2020 - Evaluation of a Long-Acting Opioid Restriction Policy: Does Restriction Reduce the Need for Naloxone Reversal?
Hospital Pharmacy - February 2020 - 33
Hospital Pharmacy - February 2020 - 34
Hospital Pharmacy - February 2020 - 35
Hospital Pharmacy - February 2020 - 36
Hospital Pharmacy - February 2020 - Off-label Medications Use in the Eastern Province of Saudi Arabia: The Views of General Practitioners, Pediatricians, and Other Specialists
Hospital Pharmacy - February 2020 - 38
Hospital Pharmacy - February 2020 - 39
Hospital Pharmacy - February 2020 - 40
Hospital Pharmacy - February 2020 - 41
Hospital Pharmacy - February 2020 - 42
Hospital Pharmacy - February 2020 - 43
Hospital Pharmacy - February 2020 - Piperacillin-Tazobactam Versus Carbapenems for the Treatment of Nonbacteremic Urinary Tract Infections due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae
Hospital Pharmacy - February 2020 - 45
Hospital Pharmacy - February 2020 - 46
Hospital Pharmacy - February 2020 - 47
Hospital Pharmacy - February 2020 - 48
Hospital Pharmacy - February 2020 - 49
Hospital Pharmacy - February 2020 - Factors Associated With Increased Hospital Length of Stay in Peritoneal Dialysis Patients With Peritonitis: A Need for Antimicrobial Stewardship?
Hospital Pharmacy - February 2020 - 51
Hospital Pharmacy - February 2020 - 52
Hospital Pharmacy - February 2020 - 53
Hospital Pharmacy - February 2020 - 54
Hospital Pharmacy - February 2020 - 55
Hospital Pharmacy - February 2020 - 56
Hospital Pharmacy - February 2020 - 57
Hospital Pharmacy - February 2020 - The Clinical and Financial Impact of a Pharmacist-Driven Penicillin Skin Testing Program on Antimicrobial Stewardship Practices
Hospital Pharmacy - February 2020 - 59
Hospital Pharmacy - February 2020 - 60
Hospital Pharmacy - February 2020 - 61
Hospital Pharmacy - February 2020 - 62
Hospital Pharmacy - February 2020 - 63
Hospital Pharmacy - February 2020 - Prolonged Versus Short Infusion Rates of IV Magnesium in Hospitalized General Medicine Patients with Hypomagnesemia
Hospital Pharmacy - February 2020 - 65
Hospital Pharmacy - February 2020 - 66
Hospital Pharmacy - February 2020 - 67
Hospital Pharmacy - February 2020 - 68
Hospital Pharmacy - February 2020 - Ischemic Stroke Symptoms After Warfarin Reversal With 4-Factor Prothrombin Complex Concentrate Case Report
Hospital Pharmacy - February 2020 - 70
Hospital Pharmacy - February 2020 - 71
Hospital Pharmacy - February 2020 - 72
Hospital Pharmacy - February 2020 - Cover3
Hospital Pharmacy - February 2020 - Cover4
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