<prompt> A 65 years old male having chronic renal disorder gives history of constipation with taking of Mg Cl2 in food supplements antaacids electrolyte measure denotes hypermagnesemia clinically detects at bed side byLoss of deep tendon reflexes.Respiratory arrestFlaccid paralysisUrinary retension  <response>: Loss of deep tendon reflexes 775- CMDT-08 2373-HI7ihHYPERMAGNESEMIA - Almost always associated with advanced stages of chronic Kidney disease and a history of chronic intake of magnesium containing drugs Hypotension refractory to vasopressures or volume expansion may be an early sign 2373-H7th Muscle weakness, decreased deep tendon reflexes, mental obtundation and confusion are characteristic Weakness- even flaccid paralysis - ileus, urinary retension, hypotension There may be respiratory muscle paralysis or cardiac arrest ECG shows - Increased PR interval, broadened QRS complexes and peaked T wavesTreatment of choice - is calcium chloride Calcium acts as an antagonist to Mg Hemodialysis or peritoneal dialysis when there is severe renal failure 