Hypermagnesemia: antagonism and removal
Educational use only. Not clinically reviewed78-year-old woman for Qualified breathing and circulation support, exposure review, individualized magnesium removal, reassessment, and unresolved-risk handoff. About 60 simulated minutes.
What you will practise
- Support breathing and circulation while stopping further magnesium exposure.
- Interpret magnesium exposure alongside kidney function and bedside toxicity.
- Separate temporary antagonism from qualified magnesium removal.
- Distinguish current magnesium, neuromuscular findings, and supported breathing.
- Transfer unresolved toxicity with explicit support and removal ownership.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Nishikawa M, et al. The characteristics of patients with hypermagnesemia who underwent emergency hemodialysis. Acute Medicine & Surgery. 2018;5:222–229. doi:10.1002/ams2.334. A 15-patient primary series supports the clinical distinction between toxicity and qualified removal; it is not a treatment protocol or validation of this authored trajectory.
- Bansal AD, Negoianu D, Warburton KM. An Unusual yet “Mg”nificent Indication for Hemodialysis. Seminars in Dialysis. 2016;29:247–250. doi:10.1111/sdi.12479. A single Renacidin-associated case, not an oral magnesium protocol; it does not validate the authored calcium-effect duration.
- Jou DH, et al. Fatal hypermagnesemia in patients taking magnesium hydroxide. Electrolyte & Blood Pressure. 2023;21:66–71. doi:10.5049/EBP.2023.21.2.66. Two oral magnesium hydroxide cases support exposure and gastrointestinal-context review, not a predicted response curve or universal threshold.
- DailyMed. Hospira magnesium sulfate in 5% dextrose injection prescribing information. Revised June 2026; updated August 24, 2026; checked August 27, 2026. Respiratory assessment, calcium antagonism, and renal risk inform safety boundaries; this intravenous-product label is not an oral-toxicity treatment protocol.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.