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Serum magnesium is a poor measure of total body magnesium as only a small fraction is within serum. One could make the argument for empiric magnesium replacement if the potassium is low as these electrolyte abnormalities often present together. Magnesium replacement is generally extremely safe with two exceptions. One being a patient with myasthenia gravis where magnesium administration may worsen muscle weakness. The other is the patient with renal failure.
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