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ARTICLE |

Thiazide-lnduced Hypomagnesemia FREE

Michael J. Moore, MD
JAMA. 1978;240(12):1241-1241. doi:10.1001/jama.1978.03290120035018
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To the Editor.—  A recent issue had an interesting article entitled "Thiazide-Induced Hypokalemia: Association With Acute Myocardial Infarction and Ventricular Fibrillation" (239:43, 1978). I saw nowhere in it references to serum magnesium in such patients or discussions of the importance of it. This has been written about for several years,1,2 but the information does not appear to have had wide dissemination. Burch and Giles3 have recently reviewed this topic, and Flink and associates4-6 have done extensive research and writing on magnesium deficiency and toxicity.Diuretics can cause both hypokalemia and hypomagnesemia, and if hypomagnesemia is present, it is essentially impossible to correct the hypokalemia. As a matter of fact, it is a routine order for the coronary care unit nurses in our hospital to obtain the serum magnesium level of new patients who have been taking diuretics for any appreciable length of time. This applies to patients

REFERENCES

Loeb HS, Petras RJ, Gunnar RM, et al:  Paroxysmal ventricular fibrillation in two patients with nypomagnesemia . Circulation 37:210-215, 1968;.
Iseri LT, Freed J, Bures AR:  Magnesium deficiency and cardiac disorders . Am J Med 58:837-846, 1975;.
Burch GE, Giles TD:  The importance of magnesium deficiency in cardiovascular disease . Am Heart J 94:649-657, 1977;.
Flink EB:  Magnesium deficiency and magnesium toxicity in man , in Prasad AS (ed): Trace Elements in Human Health and Disease . New York, Academic Press, vol 2, pp 1-21, 1976;.
Flink EB:  Magnesium deficiency . Rocky Mountain Med J 71:390-395, 1974;.
Flink EB, Stutzman FL, Anderson AR, et al:  Magnesium deficiency after prolonged parenteral fluid administration and after chronic alcoholism complicated by delirium tremens . J Lab Clin Med 43:169, 1954;.
Moore MJ:  Oral therapy for hypomagnesemia . Va Med 105:232-233, 1978;.

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Loeb HS, Petras RJ, Gunnar RM, et al:  Paroxysmal ventricular fibrillation in two patients with nypomagnesemia . Circulation 37:210-215, 1968;.
Iseri LT, Freed J, Bures AR:  Magnesium deficiency and cardiac disorders . Am J Med 58:837-846, 1975;.
Burch GE, Giles TD:  The importance of magnesium deficiency in cardiovascular disease . Am Heart J 94:649-657, 1977;.
Flink EB:  Magnesium deficiency and magnesium toxicity in man , in Prasad AS (ed): Trace Elements in Human Health and Disease . New York, Academic Press, vol 2, pp 1-21, 1976;.
Flink EB:  Magnesium deficiency . Rocky Mountain Med J 71:390-395, 1974;.
Flink EB, Stutzman FL, Anderson AR, et al:  Magnesium deficiency after prolonged parenteral fluid administration and after chronic alcoholism complicated by delirium tremens . J Lab Clin Med 43:169, 1954;.
Moore MJ:  Oral therapy for hypomagnesemia . Va Med 105:232-233, 1978;.
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