The effect of magnesium on erythrocytic electrolytes in digitalis toxicity

Abstract

Concentrations of K⁺, Na⁺ and Mg⁺⁺ were measured in plasma (K⁺_e, Na⁺_e, Mg⁺⁺_e) and in erythrocytes (K⁺_i, Na⁺_i, Mg⁺⁺_i) in patients with digitalis toxicity before and after administration of Mg. K⁺ concentration in 24-hour urine was also measured. 70 persons were divided into 5 groups: (1) 11 normal persons as controls; (2) 19 patients with congestive heart failure, in whom Mg⁺⁺_i and Mg⁺⁺_e concentrations were found to be lower than that of the control group; (3) 16 patients with digitalis toxicity treated by Mg⁺⁺, whose K⁺_i concentration increased much quicker, and Na⁺_i and Na⁺_i/K⁺_i decreased remarkably in comparison to non-Mg treatment group; (4) 12 patients with digitalis toxicity not treated by Mg⁺⁺: in these the above-mentioned changes were not significant; (5) 12 patients with arrhythmia of other causes treated by Mg⁺⁺: whose K⁺_i also increased significantly on the 3rd day after treatment.

K⁺ concentration in 24-hour urine was much lower in Mg treatment group than in non-Mg treatment group.

Besides, acute digitalis toxicity was observed in experimental dogs. The concentration of K⁺_i recovered much quicker in Mg treatment group than in control group.

These findings indicate that hypomagnesemia may induce digitalis toxicity. In this paper the possible mechanism of the therapeutic effect of Mg in the treatment of digitalis toxicity is discussed.

Keywords

Mg⁺⁺ in REC / Na⁺ in RBC / K⁺ in RBC / digitalis toxicity and treatment

References

[1] YexinMa, HuayueZhao. The significance of determination of Na⁺, K⁺ in red blood cells in diagnosis and management of digitalis intoxicaion. Acta Acad Med Wuhan, 1982, 2(2): 103-103

[2] AderoumuAF, et al.. Abnormal cation composition and transport in erythrocytes from hypertensive patients. Eur J Clin Invest, 1979, 8: 369-369

[3] WesselsF, et al.. Diagnose der Digitalisintoxikation durch Bestimmung der Erythrocyten — Elektrolyte. Klin Wochenschr, 1974, 52: 451-451

[4] LimP, et al.. Magnesium deficiency in patients on long term diuretic therapy for heart failure. Br Med J, 1972, 3: 620-620

[5] SellerRH, et al.. Serum and erythrocytic magnesium levels in congestive heart failure: Effect of hydrochlorothiazide. Am J Cardiol, 1966, 17: 786-786

[6] SellerRH, et al.. Digitalis toxicity and Hypomagnesemia. Am Heart J, 1970, 79(1): 57-57

[7] CritellG, et al.. L’action antiarrhythmique des cations de magnesium. Arch Mal Coeur, 1979, 72(6): 879-879

[8] DycknerT, et al.. Ventricular extrasystoles and intracellular electrolytes before and after potassium and magnesium infusions in patients on diuretic treatment. Am Heart J, 1979, 97(1): 12-12

[9] DycknerT, et al.. Relation between potassium, magnesium and cardiac arrhythmias. Acta Med Scand, 1980, 647: 163-163

[10] DycknerT, et al.. The relation between extra- and intracellular electrolytes in patients with hypokalemia and/ or diuretic treatment. Acta Med Scand, 1978, 204: 269-269

[11] NeffMS, et al.. Magnesium sulfate in digitalis toxicity. Am J Cardiol, 1972, 29: 377-377