The clinical relevance of magnesium replacement is until today unclear. Consciousness is worsened by high magnesium levels. For correction of severe hypomagnesaemia with or without concomitant severe cardiac arrhythmia and heart failure, magnesium can be given as magnesium sulfate in a dose of 0.5g/hr (2 mmol/hr) for 24 hours laboratory controls should be performed at least every 12 hours. In cases of ventricular tachycardia one can give 1 to 2 f (2-4 mL 50% MgSO4, corresponding to 8-16 mval or 4-8 mmol) in 10 mL glucose 5% for 1 to 2 minutes; in cases of ventricular fibrillation also as bolus. The maximal dose of magnesium corresponds to 50 mmol/day; in cases of renal insufficiency the dose has to be adapted. The antidote to magnesium is calcium gluconate, e.g., 1 g infused slowly in i.v.
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