and Lpez-Cabezas et al. It would be good to have greater uniformity in the quality standards of this type of studies. After the reference search, 2 independent reviewers assessed the quality of the studies using a peer-review process. 1968-1969. On the contrary, 81% of the studies followed the recommendation of taking samples at time 0, although only 10 obtained a sample in 5 different times. WebThe compatibility and stability of 80 mmol/L potassium chloride and 16 mmol/L magnesium sulfate in 0.9% sodium chloride injection and in 5% dextrose injection solutions at 22 deg C have been studied by means of a Beckman Clinical Chemistry Analyzer Synchron CX5 Delta. 2. Only about 2% of the total Mg2+ in the body is in the plasma. Stewart, F.W. This can be run either through a central line, or split into two 10 mEq/hr infusions through two. The compatibility of these is shown in Fig. Commonly used rate for routine potassium repletion. However, this does not necessarily mean there are no interactions. Montse Rodrguez Reyes: study design and idea, data mining, analysis and interpretation of data; paper draft or critical review of the intellectual material; and final approval of this version. S.E. IV magnesium may be the fastest way to reduce the risk of arrhythmia (because magnesium can be given rapidly). hb```l\ cg`a" D@M70I?@C Z|`d>!-Uu>]ppX=+c(rJT'c9V{L7M{{]ua;DVo"6e\W:qcf/f3%dayw-LrO{.p*zvTSf1xpSIC a. For patients with hypokalemia plus hypomagnesemia, a reasonable strategy is often to treat the hypomagnesemia fairly. sharing sensitive information, make sure youre on a federal In the absence of the above factors, hypokalemia is well tolerated (and can be treated gradually). The magnesium was piggybacked onto the other saline IV with the potassium. Specializes in NICU, PICU, Transport, L&D, Hospice. Secondary to another electrolyte abnormality: Polyuria with increased distal delivery of sodium and water to the tubule: Potassium wasting diuretics (e.g. 483-486. The compatibility and stability of 80 mmol/L potassium chloride and 16 mmol/L magnesium sulfate in 0.9% sodium chloride injection and in 5% dextrose injection solutions at 22 deg C have been studied by means of a Beckman Clinical Chemistry Analyzer Synchron CX5 Delta. #1) Familial form with onset <20 years old. WebC = Compatible; may be mixed via Y-site. $MMT=window.$MMT||{};$MMT.cmd=$MMT.cmd||[];$MMT.cmd.push(function(){$MMT.display.slots.push(["e023039a-a41d-404b-ba77-d0a561240f4b"]);}). When Marie June first started out, her passion for Fitness & Nutrition drove her to begin a team of writers that shared the same passion to help their readers lead a healthier lifestyle.We hope you enjoy our articles as much as we enjoy offering them to you. Stability of meropenem in saline and dextrose solutions and compatibility with potassium chloride. 2980 0 obj <>stream Use serum magnesium values to guide continued dosage. Physical Compatibility: Physically compatible. According to Lexicomp, these are compatible, and there are no warnings against infusing concomitantly - is there any reason you couldn't run them together? The problem is that magnesium blocks potassium secretion back OUT of the cell, and with low intracellular mag levels, potassium is allowed to freely exit the cell. Some experts recommend 2550 mg/kg (up to 2 g) every 46 hours for 34 doses; repeat as needed. For example: In a patient with normal renal function and K = 3 mM (estimated deficiency of ~100-200 mEq), a dose of 40 mEq KCl could be given q8hr with daily measurement of electrolytes. Specializes in MPH Student Fall/14, Emergency, Research. Dolors Soy Muner: study design and idea; paper draft or critical review of the intellectual material; and final approval of this version. 71-78. 516-520. %%EOF Your email address will not be published. Maddox, K. Viswanathan, J.L. Se incluyeron los estudios publicados entre 1990 y 2017 redactados en ingls, espaol y francs; 2) se analiz la calidad de los artculos segn los criterios indicados en las guas de prctica para estudios de estabilidad; 3) se construy una tabla de compatibilidades con los datos hallados para las combinaciones binarias de 44 frmacos de uso frecuente en unidades de cuidados intensivos (UCI). Am J Health Syst Pharm, 72 (2015), pp. Am J Health Syst Pharm, 54 (1997), pp. consider target potassium level (more) Potassium citrate be useful in patients with nonanion-gap metabolic acidosis (NAGMA). Published data may report both compatibility and stability; however, most evaluate compatibility alone. Select a second drug the same way (limited to 2 drugs) 3. Table 2. S. Tollec, K. Touzin, E. Pelletier, J.M. consider target potassium level (more) WebThe primary endpoint of the study (change in serum magnesium level after 6 to 24 hours) was greater with IV therapy than any dose of oral therapy (mean change 0.24 mg/dL vs. 0.05-0.11 mg/dL, p=0.003). hb``b``g```1c@@,&a|sR9TzxYeK Can You Give Po And Iv Potassium Together? May consider checking a full electrolyte panel (including Calcium, Magnesium, and Phosphate): Electrolyte abnormalities often occur in pairs and triplets (electrolytic disarray). This review was conducted following quality criteria based on the opinion of experts and following clinical practice guidelines811: Study reproducibility: description of active ingredient and diluent, study conditions and methodology. Please enable it to take advantage of the complete set of features! J Cardiovasc Electrophysiol. Chemical Stability: Chemically stable. Round IV supplementation to the nearest 7.5 or 15 mmol increment 1.6-2.3 mg/dL Phosphate-potassium packet (PHOS-NAK powder) 2 (two) packets every 4 hours while awake x 3 dosesB Phosphate-potassium packet (PHOS-NAK Avoid or use alternate Drug. Forty-four drugs used in continuous perfusion at the ICU setting were selected including a solution for parenteral nutrition with and without lipids and 3 beta-lactam antibiotics. Compatibilit du pantoprazole injectable lors dadministration en Y. Potassium is flowing into the cells just fine. Is Potassium Phosphate Compatible With Potassium Chloride? WebIntravenous administration of magnesium and potassium solution lowers energy levels and increases success rates electrically cardioverting atrial fibrillation J Cardiovasc Electrophysiol. Rehak, R.L. (iii) A compatibility table was produced with data for 44 binary combinations of drugs frequently used in the ICU. D. Brossard, V. Chedru-Legros, S. Crauste-Manciet, S. Fleury-Souverain, F. Lagarce, P. Odou. (3) Safer (oral potassium is overall more idiot-proof than IV potassium). Storage: Room temperature of 22 C. Am J Hosp Pharm, 40 (1983), pp. As far as the magnesium goes we don't piggyback it most of the time. Compatibility of parenteral furosemide with seventeen secondary drugs used in standard concentrations. Clipboard, Search History, and several other advanced features are temporarily unavailable. Less than 5% change in measured potassium and magnesium concentrations occurred in 24 hours. Has 10 years experience. Pharm Technol Hosp Pharm, 2 (2017), pp. Thus, if this allegedly compatible mix is performed in physiological serum, a loss of concentration of amiodarone can occur with the corresponding risk of lack of therapeutic response. Our mission is to Empower, Unite, and Advance every nurse, student, and educator. WebMany people may need magnesium supplements. Mmmm, sort ofintracellular Mg2+ modulates the transport of K+ *OUT* of cells by blocking secretion of K+, so if there is a deficiency of intracellular Mg2+, then more K+ is secreted by the distal renal tubule. For patients with oliguria or renal insufficiency, closer monitoring is required to avoid overshoot hyperkalemia. The effect of nimodipine, fentanyl and remifentanil intravenous products on the stability of propofol emulsions. The research was published in the journal Neurotypical and was released online on December 4, 2013. Ann Pharm Franaises, 69 (2011), pp. Regarding the dates of publication, 8 papers were published between 1990 and 1999, 10 between 2000 and 2009, and the remaining 11 papers were published between 2010 and 2017. Use serum magnesium values to guide continued dosage. Boxes were named with a C if the mix was compatible, with an I if incompatible and with I/C if stability depended on special conditions. Federal government websites often end in .gov or .mil. It is important to recognize that compatibility is not just Compatibility depends upon many factors including temperature, pH, IV fluid, concentration, order of mixing and brand of drug. J Cardiovasc Electrophysiol. Web1. According to the systematic review conducted by Moyen et al. Former authors have published reviews of these characteristics. Before taking any of your medications, always consult with your healthcare specialist. Stability and compatibility study of cefepime in comparison with ceftazidime for potential administration by continuous infusion under conditions pertinent to ambulatory treatment of cystic fibrosis patients and to administration in intensive care units. Administer IV dose over 2 to 3 hours for mild or moderate hypophosphatemia and over 6 to 8 hours for severe hypophosphatemia 18. Rapid administration may cause serum levels to be elevated (even though there is a total-body potassium deficit!). Lineberger. It takes 3-4 hours for the Mg2+ in kidney and heart cells to exchange with the Mg2+ in plasma, meaning that you should give the mag first so it has time to start moving into the cells so that it is more likely to be effective in blocking potassium excretion. Boxes with diagonal lines show compatibility with physiological serum only. In my time there we have still never used IV potassium and opt for PO k-dur instead. Compatibilidad fsica del bicarbonato sdico con frmacos de uso frecuente en la unidad de cuidados intensivos. Less than 5% change in measured potassium and magnesium concentrations occurred in 24 hours. IV magnesium may be the fastest way to reduce the risk of arrhythmia (because magnesium can be given rapidly). Visual compatibility of diltiazem injection with various diluents and medications during simulated Y-site injection. Physical compatibility of magnesium sulfate and sodium bicarbonate in a pharmacy-compounded hemofiltration solution. A chance of incompatibility exists whenever any medication is combined or added to an IV fluid. Sodium-wasting nephropathy (e.g. Published data may report both compatibility and stability; however, most evaluate compatibility alone. Stability of ranitidine hydrochloride at dilute concentration in intravenous infusion fluids at room temperature. The resulting salt can then be reconstituted by recrystallization. CiteScore measures average citations received per document published. Unable to load your collection due to an error, Unable to load your delegates due to an error. Inverted T-wave followed by prominent U-wave may create a biphasic down-up morphology. As Fig. What Are The Benefits Of Exercising Daily. Propofol compatibility with other intravenous drug products-two new methods of evaluating IV emulsion compatibility. )J23~v1aYz qL4p}t%& WebTherefore, the final table shows the compatibility data of 475 out of 945 possible combinations of 2 drugs (50.3%). C. Bardin, A. Astier, A. Vulto, G. Sewell, J. Vigneron, R. Trittler. Our members represent more than 60 professional nursing specialties. eplerenone and potassium. Our research goal was to investigate three combinations of potassium, calcium, and magnesium, in the event of a subsequent trial, to determine the relationships nature. Clinical review: medication errors in critical care. Torsades de pointes may be the most classic. Choosing a specialty can be a daunting task and we made it easier. RELATED: What Does Potassium Chloride React With? J.R. Chalmers, M.B. Es usted profesional sanitario apto para prescribir o dispensar medicamentos? Just out of curiosity, what order did the MD write for them in? Index Medicus / MEDLINE / EMBASE / Excerpta Medica / SCOPUS / MEDES / Science Citation Index Expanded, Journal of Citation Reports, The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. If the etiology of hypokalemia remains elusive, the following approach may be helpful: This be calculated based on spot urine potassium and creatinine levels (using a calculator found. WebIv Medication Solution Compatibility Chart For Nurses Uploaded by: run.rebel.run April 2020 PDF Bookmark Download This document was uploaded by user and they confirmed that they have the permission to share it. The anti-depressant is an antipsychotic derivative of antihystericicineineine. Recently I had a patient that needed both iv k and iv mag. F. Flamein, L. Storme, A. Maiguy-Foinard, M. Perez, B. Dcaudin, M. Masse. Magnesium plays many crucial roles in the body, such as supporting muscle and nerve function and energy production. Magnes chloride and potassium metal reactions are generally described as a single displacement reaction. La revisin sistemtica incluy 29 artculos (27 originales y 2 revisiones). hbbd```b``" mT|"e?HiA09DJYY R fIF^-0[D_ e:L ; ^ 373 0 obj <>stream A chart was created with all the possible combinations of the drugs of interest. Compatibility of propofol, fentanyl, and vecuronium mixtures designed for potential use in anesthesia and patient transport. The authors declared no conflicts of interest whatsoever. endstream endobj 2944 0 obj <>stream A clear and con-cise compatibility chart can be a useful tool in helping to deliver safe, high-quality IV therapy to patients. Sociedad Espaola de Medicina Intensiva, Crtica y Unidades Coronarias, rea del Medicamento. 1159-1160. It's usually best to be conservative in the absence of any specific factors which increase the risk of arrhythmia (see risk stratification above). Furosemide, for example, requires a basic pH to guarantee the stability of the molecule in solution, which is why the mix with acid drugs (pH<4) causes turbidity and precipitation.12. Over the last few years, several experts have published guidelines for the design of drug stability studies.811 We can only hope that this will improve the overall quality of this type of studies in the future. @Z-!/^0B"oxC(cbS8v^zjx?N3Ggf&;V7Jmm *ZDkQ}:TpE E[$c. Avoiding common flaws in stability and compatibility studies of injectable drugs. 221-231. However, chronically low levels can increase the risk of high blood pressure, heart disease, type 2 diabetes and osteoporosis. Down-titrate the rate rapidly as the EKG improves and the patient stabilizes. Web1. 8600 Rockville Pike Chemical Stability: Chemically stable. /`p Our review is based on the previous work done by Kanji et al.5 in Canada and Lpez-Cabezas.7 in Spain. Summary of physical and chemical compatibilities. Carmen Lpez Cabezas: study design and idea, data mining, analysis and interpretation of data; paper draft or critical review of the intellectual material; and final approval of this version. J.D. It has been completed with the new information available on drugs in our setting and data on the most widely used concentrations of drugs. In my time there we have still never used IV potassium and opt for PO k-dur instead. Clinical context where potassium is likely to fall further (e.g. Specializes in Trauma/ED. Visual compatibility of amiodarone hydrochloride injection with various intravenous drugs. On the other hand, in many cases, the quality of the studies published so far can be better. Cardiac arrest due to hypokalemia (e.g. When started up again the Iv with the magnesium had blown. M. Maqueda-Palau, E. Prez-Juan, M.J. Arvalo-Rubert, S.M. Search for and click on a drug 2. Web17. Another highly recommended measure for the safe administration of drugs is having reliable information available on drug compatibility when administering common drugs in critically ill patients. Nevertheless, the drugs and concentrations selected are the most widely used in the adult ICUs of most hospitals. For deficiency that is not severe in older children, some manufacturers have recommended 1 g (2 mL of 50% solution) once or twice daily by IM injection. Low magnesium levels usually don't cause symptoms. Martn, A. Alonso, I. Gutirrez, J. lvarez, F. Becerril. There were no interactions between Effervescent Potassium / Chloride and potassium phosphate & sodium phosphorus. HHS Vulnerability Disclosure, Help Foushee, L.M. Also, the information provided is in regard to 2 drug combinations, and incompatibilities may be present with>2 drug combinations at a time, which is highly not advisable. Medicina Intensiva is the journal of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICIUC), and has become the reference publication in Spanish in its field. Round IV supplementation to the nearest 7.5 or 15 mmol increment 1.6-2.3 mg/dL Phosphate-potassium packet (PHOS-NAK powder) 2 (two) packets every 4 hours while awake x 3 dosesB Phosphate-potassium packet (PHOS-NAK Compatibility of remifentanil hydrochloride with selected drugs during simulated Y-site administration. International Journal of Pharmaceutical Compounding. In the context of an ICU patient with no obvious GI potassium losses, persistent/recurrent hypokalemia implies renal potassium wasting. Potassium chloride is inexpensively available and is rarely used in the laboratory. So, potassium uptake is Potassium is flowing into the cells just fine. RELATED: What Does Potassium Chloride React With? Added to the risk of complications associated to the administration of 2 incompatible molecules, this lack of information can make the nurse have to look for new venous accesses to administer the drugs separately whichincreases the risk of infectious or thromboembolic complications. To gather all published information about the stability of drugs commonly used in Intensive Care Units (ICU); evaluate the methodology of published data; and generate a compatibility table. Therefore, the final table shows the compatibility data of 475 out of 945 possible combinations of 2 drugs (50.3%). RELATED: What Does Potassium Chloride React With? Select a second drug the same way (limited to 2 drugs) 3. Int J Pharm Compd. Administracin segura de medicamentos intravenosos en pediatra: 5 aos de experiencia de una unidad de cuidados intensivos peditricos con bombas de infusin inteligentes. Akkerman, H. Zhang, R.E. WebThe primary endpoint of the study (change in serum magnesium level after 6 to 24 hours) was greater with IV therapy than any dose of oral therapy (mean change 0.24 mg/dL vs. 0.05-0.11 mg/dL, p=0.003). For deficiency that is not severe in older children, some manufacturers have recommended 1 g (2 mL of 50% solution) once or twice daily by IM injection. N. Baririan, H. Chanteux, E. Viaene, H. Servais, P.M. Tulkens. Webmagnesium and potassium solutions in the Intravenous reduces energy levels and raises the possibility of electrocardiographic fibrillation. Search focused on drug combinations on which these authors had no information or had not looked for information. WebTherefore, the final table shows the compatibility data of 475 out of 945 possible combinations of 2 drugs (50.3%). $MMT=window.$MMT||{};$MMT.cmd=$MMT.cmd||[];$MMT.cmd.push(function(){$MMT.display.slots.push(["bf84ea07-bd33-4824-bab3-02410772e6f3"]);}). Then get the mag started. P. Merino, M.C. 307-309, Copyright 2018. Vasoactive drugs, analgesics, and sedatives are among the most widely used therapeutic groups and are usually administered in continuous infusion. Therefore, the potassium deficit may be even, The vast majority of potassium in the body is located intracellularly. Epub 2011 Aug 4. 2012 Jan;23 (1):54-9. doi: 10.1111/j.1540-8167.2011.02146.x. Serum hyperkalemia is dangerous. Potassium is flowing into the cells just fine. In my time there we have still never used IV potassium and opt for PO k-dur instead. By using the site you agree to our Privacy, Cookies, and Terms of Service Policies. A total of 48 papers were identified. Nieforth KA, Shea BF, Souney PF, Scavone JM. Report DMCA Overview official website and that any information you provide is encrypted Report DMCA Overview Repletion of magnesium is often necessary to successfully replete the potassium. Magnesium repletion is also useful because it will reduce the risk of Torsade de pointes in these patients. Forest. The patient had one patent iv site. This study guide will help you focus your time on what's most important. Am J Health Syst Pharm, 65 (2008), pp. Copyright 2009-. %%EOF WebIV Drug Compatibility Chart A Alteplase (Activase, rTPA) Amiodarone (Cordarone) Argatroban Atropine Calcium chloride Diltiazem (Cardizem) Dobutamine (Dobutrex) Dopamine Epinephrine (Adrenalin) Esmolol (Brevibloc) Furosemide (Lasix) Heparin Insulin (regular) Lidocaine (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate hSMxv? I sat upright and called for the nurse. Administer IV dose over 2 to 3 hours for mild or moderate hypophosphatemia and over 6 to 8 hours for severe hypophosphatemia 18. Has 10 years experience. Study drugs and concentrations used as reference for the bibliographic search. Also, to assess the quality of the information published and generate a compatibility chart with reliable and updated information to improve safety in the administration of drugs to critically ill patients. Some experts recommend 2550 mg/kg (up to 2 g) every 46 hours for 34 doses; repeat as needed. Medicina Intensiva mainly publishes Original Articles, Reviews, Clinical Notes, Images in Intensive Medicine, and Information relevant to the specialty. Militello. If you have persistently low blood magnesium levels, this could lead to low potassium and calcium levels. M/Metadata 31 0 R/PageLayout/OneColumn/Pages 2938 0 R/StructTreeRoot 35 0 R/Type/Catalog>> endobj 2942 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 2943 0 obj <>stream S. Manrique-Rodrguez, A.C. Snchez-Galindo, C.M. Thank you you for your response to that ? Use Alternative Drug. Repletion of magnesium is often necessary to successfully replete the potassium. WebMagnesium Sulphate Mannitol Metronidazole Midazolam Labetalol Gentamicin Glucose 4%, Sodium Chloride 0.18% Glucose 5% Glyceryl Trinitrate (GTN) Heparin (Sodium) Potassium Chloride Potassium Phosphate Propofol Remifentanil Milrinone Morphine Noradrenaline Omeprazole Thiopental Vancomycin None of the included studies followed all the methodological requirements. Before A chance of incompatibility exists whenever any medication is combined or added to an IV fluid. None of the samples appeared to form visible precipitation or to change in color or clarity. Webcompatibility prior to coadministration. It is important to recognize that compatibility is not just solutions. Bethesda, MD 20894, Web Policies Mmmm, sort ofintracellular Mg2+ modulates the transport of K+ *OUT* of cells by blocking secretion of K+, so if there is a deficiency of intracellular Mg2+, then more K+ is secreted by the distal renal tubule. WebMany people may need magnesium supplements. Med Intensiva. The IV was shut off. %PDF-1.5 % It can be made by treating potassium hydroxide (or other potassium bases) with hydrochloric acid: KOH + HCl + H2O. Stability of milrinone lactate in the presence 29 critical care drugs and 4 i.v. WebCompatible: metronidazole, ranitidine, vancomycin Intermittent Infusion 30-60 minutes Dilute with 50-100ml NS, G. Preferred concentration 2.5mg/ml in NS. The study contributes to the safe administration of intravenous drugs in critical patients with a view to avoiding adverse events in this frail population. Furthermore, serum hyperkalemia may cause poor retention of potassium (as it will tend to encourage potassium excretion in the urine). hbbd```b`` =wK"`RL Qn dX1DMZBAXD$ f\`6X Av0 6bfHRkm 1R&l).9f@wO&F`GI [^q Study drugs and concentrations used as reference for the bibliographic search. Cells with low potassium are leaking the potassium they are receiving right back out, which decreases the net uptake and secretion. Compatibility depends upon many factors including temperature, pH, IV fluid, concentration, order of mixing and brand of drug. 1-612-816-8773. However, chronically low levels can increase the risk of high blood pressure, heart disease, type 2 diabetes and osteoporosis. This is especially interesting in urgent situations when any delays caused by the healthcare providers can have consequences in the patient. The mix of incompatible drugs is a medication error that can have serious consequences for the patient such as therapeutic failures, micro-embolism or toxicity.4, The Y-site infusion of 2 drugs requires both drugs to be physically compatible.5 This coadministration occurs when mixing drugs in a 1:1 ratio and in the absence of visible signs of incompatibility like precipitation or change in color. This is particularly true in oliguric renal failure, wherein there is little risk that the patient will suddenly develop worsening hypokalemia. IV magnesium may be the fastest way to reduce the risk of arrhythmia (because magnesium can be given rapidly). According to the Linus Pauling Institute, all adults over the age of 19 require 4,700 milligrams of potassium per day. Stability and compatibility of ceftazidime administered by continuous infusion to intensive care patients. Are you a health professional able to prescribe or dispense drugs? A clear and con-cise compatibility chart can be a useful tool in helping to deliver safe, high-quality IV therapy to patients. S. Kanji, J. Lam, C. Johanson, A. Singh, R. Goddard, J. Fairbairn. Clarivate Analytics, Journal Citation Reports 2021. Reference: This site needs JavaScript to work properly. Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation. and Lpez-Cabezas et al.5,7 were used as a reference point. The systematic review included 29 studies (27 originals, 2 reviews). Walker, S. Varrin, D. Yannicelli, S. Law. The magnesium level is the most important contributing factor, for several reasons: (a) Hypomagnesemia is common (most patients with hypokalemia have hypomagnesemia as well).(. WebIntravenous administration of magnesium and potassium solution lowers energy levels and increases success rates electrically cardioverting atrial fibrillation J Cardiovasc Electrophysiol. in a study conducted among Spanish hospital ICUs are a little better (1.13 medication errors for every 100 patients/day).2 Even so, medication errors are common in ICUs and require care from healthcare providers to minimize them. Time is required for potassium to enter the cells. (The main driver of hypokalemia due to gastric fluid loss is the metabolic alkalosis, so avoiding loss of gastric acid will prevent this.). Calvo-Calvo, . Carrillo-lvarez, M. Sanjurjo-Sez. Out of the 29 papers included in the review, 4 were written in Spanish, 3 in French, and 22 in English. An evidence-based potassium target for cardiac patients would therefore seem to be >3.5 mM. v]"^{ ?5iLuQaU.f.1&fU\G;*=Wxtz6IF/5:Z55el6hCAj|]r8-]TOa.0-DEllb uCcP|v&,g'6x"n|gM,pQY}f}Q~ 1rZW_1aQ& i'yJ<8hBI0f`~Cc]l;So8>(P|;7d>XQ&@K;ra`HNi11,o_N*k2'R>!^7& fMnfclfMq1X< 'jjJU**;&2QTmN.bJVB}} q|=yxxEdjgauNX 6cVV I"r|NiaUvzY]Oy K#0@'YVio|{G@ ;|'mYV? Only about 2% of the total Mg2+ in the body is in the plasma.
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