Moderator EMEDPA Posted May 28, 2019 Moderator Share Posted May 28, 2019 older guy with throat ca who has very limited diet and is on omeprazole(you will see why this is important in a minute...) presents with full body myalgias (requiring IV fentanyl and ativan for symptomatic control ) and muscle contractions. looks like caropedal spasms but not hyperventilating. drum roll please..... lytes: magnesium 0.5 (!!!) Ca 5 (!) K 2.5 all repleted IV with significant improvement within 1 hr. admitted to obs status for serial labs and repletion. pro tip: omeprazole taken chronically depresses Mg levels.....not a great choice of med for someone on a limited diet. 3 Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted May 28, 2019 Share Posted May 28, 2019 Perfect, PERFECT example as to why these are NOT to be legacy medications.Bisphosphonates and antidepressants fall under this category as well. Quote Link to comment Share on other sites More sharing options...
MediMike Posted May 28, 2019 Share Posted May 28, 2019 Geeze! Did you happen to get an ionized Ca++? I imagine he was pretty malnourished. Lowest I've seen was a post-thyroidecromy patient who came up post-op completely contracted, no idea how long she was in PACU, total Ca was around 4ish with an ionized of 0.38 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 28, 2019 Author Moderator Share Posted May 28, 2019 4 hours ago, MediMike said: Geeze! Did you happen to get an ionized Ca++? I imagine he was pretty malnourished. Lowest I've seen was a post-thyroidecromy patient who came up post-op completely contracted, no idea how long she was in PACU, total Ca was around 4ish with an ionized of 0.38 the hospitalist probably did. Quote Link to comment Share on other sites More sharing options...
MediMike Posted May 28, 2019 Share Posted May 28, 2019 3 hours ago, EMEDPA said: the hospitalist probably did. Touche hahaha... Quote Link to comment Share on other sites More sharing options...
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