Friday January 16, 2009

Q: Which electrolytes you need to watch closely while patient receives proton pump inhibitor?


Answer: Magnesium (and potassium secondary to low magnesium)

Mechanism is not very clear. Absorption of dietary magnesium occurs in the ileum and colon via carrier mediated transport and simple diffusion. Low gastric pH is thought to be important for the absorption of minerals. Waves of acidity entering the small intestine from the stomach may help to keep mineral salts in solution until they can be absorbed. Omeprazole induced hypochlorhydria could therefore theoretically cause mineral deficiency, although there is no clear evidence proven yet.


Reference: Click to get abstract

1. Omeprazole and refractory hypomagnesaemia - BMJ 2008;337:a425
2. Epstein M, McGrath S, Law F. Proton-pump inhibitors and hypomagnesemic hypoparathyroidism. N Engl J Med2006;355:1834-6.