If magnesium toxicity occurs, the role of prompt treatment cannot be undermined. Īn interprofessional team that provides a holistic and integrated approach to care can help achieve the best possible outcomes. However, as levels continue to rise, patients experience loss of deep tendon reflexes, sinoatrial (SA) or atrioventricular (AV) node blocks, respiratory paralysis, and, eventually, cardiac arrest. The most common findings of early-onset toxicity are diarrhea, nausea and vomiting, muscle weakness, and low blood pressure. When these processes are affected, whether it is due to under-excretion by the kidneys, over-absorbance by the small bowel, or displacement of stored magnesium into the serum, hypermagnesemia occurs and leads to magnesium toxicity. Magnesium is also involved in sodium, potassium, and calcium channels. The homeostasis of magnesium depends on kidney and small bowel function and storage in bone and cells. Approximately 60% of the total is stored in bone, 39% is stored intracellularly, and only 1% is found in its free or ionized active form in blood vessels. An average adult has approximately 22 to 26 grams of magnesium. Magnesium's importance is in protein synthesis, nerve and muscle functioning, bone growth, regulation of blood pressure and glucose, and normal cardiac rhythm. Product Code: FAP 06645įor complete management information or the entire Hydrofluoric Acid monograph in the 5th edition of Poison Management Manual, contact 24-hr BC Poison Control Centre.Magnesium serves as a co-factor for over 300 biochemical reactions within the body. May be ordered from a construction supply distributor called Century Vallen:Ĭentury Vallen Order Desk: 60. Other water-based lubricants, including Taro brand gel, may be incompatible with calcium gluconate. It should thicken back into an even gel state. Mixing should be done rapidly while preparation is fairly liquid as viscosity will increase with time. It can be extemporaneously prepared or ordered from an alternative commercial supplier.Ĭalcium gluconate 2.5% gel may be prepared in a sterile container by mixing 10 mL of 10% calcium gluconate injectable solution (NOT calcium chloride injectable solution) with 30 mL K-Y® Jelly sterile lubricating gel. The commercial product, Calgonate® from Pharmascience, is not currently available. Inspect and re-dress burns every 4 hours or as required to control pain. For hand involvement, fill surgical glove with gel and leave on at least 4 hours. If symptoms recur, reapply a thick layer of gel and cover with dressing. After flushing skin with water, massage a liberal amount of calcium gluconate gel into affected areas for a minimum of 30 minutes, and for at least 15 minutes after pain resolves. It should be used initially for all exposures. Calcium gluconate 2.5% gel can minimize burn injury and control pain. Treatment for topical exposure involves immediate decontamination with large volumes of water for 15-30 minutes followed by application of topical calcium gluconate gel. Local effects of exposure range from delayed-onset pain and erythema (dilute solutions) to immediate pain with skin blanching surrounded by erythema (from higher concentrations). Hydrofluoric acid is available commercially in rust removers, wheel cleaners, and aluminum brighteners. Calcium gluconate 2.5% gel is used topically to manage deep tissue burns following exposure to hydrofluoric acid.
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