Hypermagnesemia is rare but can be seen in renal failure when pts are taking magnesium-containing antacids, laxatives, enemas, or infusions, or in acute rhabdomyolysis. The most readily detectable clinical sign of hypermagnesemia is the disappearance of deep tendon reflexes, but hypocalcemia, hypotension, paralysis of respiratory muscles, complete heart block, and cardiac arrest can occur. Treatment includes stopping the preparation, clearing the intestines of residual offending laxatives or antacids with magnesium-free enemas or cathartics, dialysis against a low magnesium bath, or, if associated with life-threatening complications, 100–200 mg of elemental calcium IV over 1–2 h.

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