Nephrology Book

http://www.fpnotebook.com/

Calcium Parenteral AdministrationAka: Calcium Replacement, Calcium Chloride, Calcium Gluconate, Calcium Gluceptate

Advertisement

  1. See Also
    1. Calcium Supplementation
  2. Mechanism of action: Cardiac effect
    1. Calcium is a positive inotrope
      1. Increases force of myocardial contraction
    2. Variable effect on systemic vascular resistance
  3. Efficacy
    1. No proven benefit in Cardiac Arrest
  4. Indications
    1. Hypocalcemia
      1. Often occurs after blood transfusion
    2. Hyperkalemia
    3. Hypermagnesemia
    4. Calcium Channel Blocker overdose or toxicity
      1. May also prevent hypotensive effect of IV agent
    5. Not indicated in:
      1. Asystole
      2. Pulseless Electrical Activity
  5. Preparation
    1. Calcium Chloride (10%): 100 mg per ml
      1. Contains 27.2 mg/ml elemental calcium
      2. Preferred Calcium preparation
      3. Drives predictably higher Serum Calcium levels
    2. Calcium Gluconate (10%)
      1. Contains 9 mg/ml elemental calcium
    3. Calcium Gluceptate
  6. Dosing: Calcium Gluconate 10%
    1. Hypocalcemia
      1. Calcium Gluconate 1 gram in 50 ml D5W over 1 hour
    2. Emergent dosing
      1. Initial: 2 ampules (20 ml) IV over 10-30 minutes
      2. Maintenance: 60ml in 500ml D5W at 0.5-2.0 mg/kg/h
  7. Dosing: Calcium Chloride (10%)
    1. General indications (e.g. Hyperkalemia)
      1. Child: 0.2 - 0.25 ml/kg given very slowly
      2. Adult: 8 - 16 mg/kg given very slowly
    2. Prophylaxis of Calcium Channel Blocker hypotension
      1. Initial: 2 - 4 mg/kg IV given very slowly
      2. Repeat as needed every 10 minutes
  8. Precautions
    1. Rapid calcium administration may result in:
      1. Bradycardia
      2. Asystole
    2. Drug interaction
      1. Digoxin: Digitalis Toxicity
      2. Sodium Bicarbonate: precipitates with calcium
    3. Coronary vasospasm
    4. Local tissue injury
      1. Peripheral vein sclerosis
      2. Local chemical burns if infiltrates into tissue
  9. Monitoring while on Calcium Infusion
    1. Follow Calcium levels every 4-6 hours

Calcium Chloride (C0006686)

Definition (MSH)A salt used to replenish calcium levels, as an acid-producing diuretic, and as an antidote for magnesium poisoning.
Definition (NCI)A crystalline, white substance, soluble in water, Calcium Chloride is the chloride salt of calcium, a bivalent metallic element with many crucial biological roles. Calcium is a major constituent of the skeleton but plays many roles as an intracellular and plasma ion as well. In medicine, calcium chloride is also used as a 10% solution in injection, for calcium replenishment. (NCI04)
ConceptsPharmacologic Substance (T121) , Inorganic Chemical (T197)
MSHD002122
EnglishAnhydrous Calcium Chloride, Calcium Chloride, Calcium Chloride Anhydrous, Calcium Chloride Hexahydrate, CALCIUM CHLORIDE PREPARATION
Spanishcloruro de calcio
Parent ConceptsChlorides (C0008203), Calcium Compounds (C0206106), Dietary Supplements (C0242295), Electrolyte Replacement Agent (C1512185), Calcium (C0006675), Calcium - dietary supplementation (C0561936)
SourcesLCH, MSH, MTHSPL, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Calcium Gluconate (C0006699)

Definition (MSH)The calcium salt of gluconic acid. The compound has a variety of uses, including its use as a calcium replenisher in hypocalcemic states.
Definition (PDQ)The gluconate salt of calcium. An element or mineral necessary for normal nerve, muscle, and cardiac function, calcium as the gluconate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39172&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39172&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C336" NCI Thesaurus)
Definition (NCI)The gluconate salt of calcium. An element or mineral necessary for normal nerve, muscle, and cardiac function, calcium as the gluconate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers. (NCI04)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD002125
EnglishCalcium D-gluconate, Calcium Gluconate, CALCIUM GLUCONATE PREPARATION, CALGLUC
Spanishgluconato de calcio
Parent ConceptsGluconates (C0017714), Dietary Supplements (C0242295), Electrolyte Replacement Agent (C1512185), Calcium (C0006675), Calcium salt (C0357197), Calcium - dietary supplementation (C0561936)
SourcesMSH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Calcium gluceptate (C0108111)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC007852
EnglishCalcium gluceptate, CALCIUM GLUCEPTATE PREPARATION, Calcium glucoheptonate
Spanishgluceptato de calcio, glucoheptonato de calcio
Parent ConceptsElectrolyte Replacement Agent (C1512185), Calcium (C0006675), alpha-glucoheptonic acid (C0051365), [GA105] CALCIUM CONTAINING ANTACIDS (C0973542), Calcium salt (C0357197)
SourcesMSH, MTH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree