Registration Dossier
Registration Dossier
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EC number: 231-104-6 | CAS number: 7439-95-4
Direct observations: clinical cases, poisoning incidents and other
Administrative data
- Endpoint:
- direct observations: clinical cases, poisoning incidents and other
- Type of information:
- migrated information: read-across from supporting substance (structural analogue or surrogate)
- Adequacy of study:
- supporting study
- Reliability:
- 2 (reliable with restrictions)
- Rationale for reliability incl. deficiencies:
- other: reasonably well-documented publication
Data source
Reference
- Reference Type:
- publication
- Title:
- Hypermagnesemia following an acute ingestion of Epson salt in a patient with normal renal function
- Author:
- Sean P. Nordt, Saralyn R. Williams, Steven Turchen, Anthony Manoguerra, David Smith, and Richard F. Clark
- Year:
- 1 996
- Bibliographic source:
- Clinical Toxicology, 34(6), 735-739
Materials and methods
- Study type:
- clinical case study
- Endpoint addressed:
- basic toxicokinetics
- acute toxicity: oral
Test guideline
- Qualifier:
- no guideline followed
- Principles of method if other than guideline:
- Testing laboratory:San Diego Regional Poison Center, University of California; san Diego Medical Center, (SPN, SRW, ST, AM, RFC); Mercy Hospital and Medical Center, San Diego, California (DS)
- GLP compliance:
- not specified
Test material
- Reference substance name:
- Magnesium sulfate, heptahydrate
- IUPAC Name:
- Magnesium sulfate, heptahydrate
- Reference substance name:
- 10034-99-8
- EC Number:
- 600-073-4
- Cas Number:
- 10034-99-8
- IUPAC Name:
- 10034-99-8
- Reference substance name:
- Magnesium sulphate
- EC Number:
- 231-298-2
- EC Name:
- Magnesium sulphate
- Cas Number:
- 7487-88-9
- IUPAC Name:
- 7487-88-9
- Reference substance name:
- Magnesium sulphate
- IUPAC Name:
- Magnesium sulphate
- Test material form:
- solid: compact
- Details on test material:
- - Epsom salt (Magnesium sulfate, heptahydrate)
Constituent 1
Constituent 2
Constituent 3
Constituent 4
Method
- Type of population:
- general
- Subjects:
- - Number of subjects exposed: 1
- Sex: Female
- Age: 47
- Race: black
- Known diseases: non-insulin-dependent diabetes mellitus, hypertension, peptic ulcer disease, pancreatitis - Ethical approval:
- not specified
- Route of exposure:
- oral
- Reason of exposure:
- intentional
- Exposure assessment:
- measured
- Details on exposure:
- The patient ingested 4 tablespoonfuls (140 mEq/17.5 g) in a single dose.
- Medical treatment:
- The patient was brought to the emergency department, and hydrated with normal saline.
Results and discussion
- Clinical signs:
- - The patient showed paralysis, difficulty speaking, and altered mental status.
- Diffuse motor weakness : 1/5 in all extremities
- hypothermic : 35 oC
- Blood pressure : 150/84 mmHg
- Respiration : 18/min
- Heart rate : 97 bpm
- Serum electrolytes : normal, except for bicarbonate 17 mEq/L, calcium 10.8 mg/dL, and Mg 18.3 mEq/L
- Renal function : normal (creatinine 1.1 mg/dL, blood Urea nitrogen 11 mg/dL)
- Arterial blood gas : pH 7.39, PCO2 32.8, PO2 78
- Computerized tomography of the head : negative
- Twelve-lead ECG : normal sinus rhythm - Results of examinations:
- Clinically significant hypermagnesemia following oral or rectal administration of magnesium containing products in patients with normal renal function is rare. We report a case of hypermagnesemia following massive Epsom salt ingestion that resulted in extreme musculoskeletal weakness and altered mentation.
- Effectivity of medical treatment:
- - 2 hours after admission
: Serum Mg-13.2 mEq/L, become less drowsy and was able to speak in complete sentences.
: Muscle strength and coordination had improved to 3/5, however, deep tendon reflexes were still absent.
- 7 hours after admission
: Serum Mg-7.2 mEq/L, serum calcium-8.7 mg/dL
- 2 days after admission (discharge)
: Serum Mg-2.3 mEq/L
Applicant's summary and conclusion
- Conclusions:
- Clinically significant hypermagnesemia following oral or rectal administration of magnesium containing products in patients with normal renal function is rare. We report a case of hypermagnesemia following massive Epsom salt ingestion that resulted in extreme musculoskeletal weakness and altered mentation.
- Executive summary:
Clinically significant hypermagnesemia following oral or rectal administration of magnesium containing products in patients with normal renal function is rare. We report a case of hypermagnesemia following massive Epsom salt ingestion that resulted in extreme musculoskeletal weakness and altered mentation.
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