A double-blind placebo-controlled crossover trial of intravenous magnesiumsulfate for foscarnet-induced ionized hypocalcemia and hypomagnesemia in patients with AIDS and cytomegalovirus infection

Citation
Mm. Huycke et al., A double-blind placebo-controlled crossover trial of intravenous magnesiumsulfate for foscarnet-induced ionized hypocalcemia and hypomagnesemia in patients with AIDS and cytomegalovirus infection, ANTIM AG CH, 44(8), 2000, pp. 2143-2148
Citations number
38
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Microbiology
Journal title
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
ISSN journal
0066-4804 → ACNP
Volume
44
Issue
8
Year of publication
2000
Pages
2143 - 2148
Database
ISI
SICI code
0066-4804(200008)44:8<2143:ADPCTO>2.0.ZU;2-8
Abstract
Foscarnet (trisodium phosphonoformate hexahydrate) is an antiviral agent us ed to treat cytomegalovirus disease in immunocompromised patients. One comm on side effect is acute ionized hypocalcemia and hypomagnesemia following i ntravenous administration. Foscarnet-induced ionized hypomagnesemia might c ontribute to ionized hypacalcemia by impairing excretion of preformed parat hyroid hormone (PTH) or by producing target organ resistance. Prevention of ionized hypomagnesemia following foscarnet administration could blunt the development of ionized hypocalcemia. To determine whether intravenous magne sium ameliorates the decline in ionized calcium and/or magnesium following foscarnet infusions, MgSO4 at doses of 1, 2, and 3 g was administered in a double-blind, placebo-controlled, randomized, crossover trial to 12 patient s with AIDS and cytomegalovirus disease, Overall, increasing doses of MgSO4 reduced or eliminated foscarnet-induced acute ionized hypomagnesemia. Supp lementation, however, had no discernible effect on foscarnet-induced ionize d hypocalcemia despite significant increases in serum PTH levels. No dose-r elated, clinically significant adverse events were found, suggesting that i ntravenous supplementation with up to 3 g of MgSO4 was safe in this chronic ally ill population. Since parenteral MgSO4 did not alter foscarnet-induced ionized hypocalcemia or symptoms associated with foscarnet, routine intrav enous supplementation for patients with normal serum magnesium levels is no t recommended during treatment with foscarnet.