Which medication is commonly associated with hypomagnesemia?

Which medication is commonly associated with hypomagnesemia?

• A. Cisplatin
• B. Acetaminophen
• C. Metformin
• D. Lisinopril

Answer: (A)

This question tests recognition of drugs that can cause magnesium loss through kidney toxicity. Cisplatin is a platinum-based chemotherapy agent that damages renal tubules, leading to renal magnesium wasting. The tubules lose their ability to reabsorb magnesium efficiently, so more magnesium is excreted in urine and serum magnesium falls, producing hypomagnesemia. Clinically, this can contribute to muscle cramps, weakness, or even arrhythmias if severe. The other medications listed are not typically associated with hypomagnesemia. Acetaminophen is not nephrotoxic in the same way regarding magnesium handling and is not known for causing low Mg. Metformin’s concerns are mainly lactic acidosis risk in renal impairment and vitamin B12 deficiency, not magnesium wasting. Lisinopril, an ACE inhibitor, can affect kidney function and electrolyte balance in other ways (like hyperkalemia) but is not a common cause of magnesium loss.

This question tests recognition of drugs that can cause magnesium loss through kidney toxicity. Cisplatin is a platinum-based chemotherapy agent that damages renal tubules, leading to renal magnesium wasting. The tubules lose their ability to reabsorb magnesium efficiently, so more magnesium is excreted in urine and serum magnesium falls, producing hypomagnesemia. Clinically, this can contribute to muscle cramps, weakness, or even arrhythmias if severe.

The other medications listed are not typically associated with hypomagnesemia. Acetaminophen is not nephrotoxic in the same way regarding magnesium handling and is not known for causing low Mg. Metformin’s concerns are mainly lactic acidosis risk in renal impairment and vitamin B12 deficiency, not magnesium wasting. Lisinopril, an ACE inhibitor, can affect kidney function and electrolyte balance in other ways (like hyperkalemia) but is not a common cause of magnesium loss.