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We found 23 abnormalities as defined by Whang and his colleagues in 18 of our 97 patients—but our statement that "hyponatremia occurred in 8%, hypokalemia in 11%, and hypomagnesemia in 4%" stands. Dr Whang is in error in summing these percentages and in stating that "they observed 23% of patients receiving digoxin to have electrolyte disturbances." Only 18 patients had one abnormality or more (one patient had low sodium, potassium, and magnesium).
Our study was carried out on patients where only digoxin estimation was requested by the physician. None was accompanied by a magnesium request. Scottish physicians rarely request the serum magnesium test and do not give magnesium therapy to digitalized patients.
We agree with Dr Whang that determination of serum magnesium should be requested more frequently by our physicians and that this would lead to improved patient care.
Gardner MD. Hypomagnesemia in Digitalized Patients-Reply. Arch Intern Med. 1986;146(3):607. doi:10.1001/archinte.1986.00360150260040
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