Nephrology Book

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Calcium Parenteral Administration

Aka: Calcium Parenteral Administration, Calcium Replacement, Calcium Chloride, Calcium Gluconate, Calcium Gluceptate
  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 BlockerHypotension
      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 Gluconate (C0006699)

Definition (NCI) The mineral calcium, combined with a form of the sugar glucose. It is used to prevent and treat bone loss. It is also being studied in the treatment of bone loss and nerve damage caused by chemotherapy.
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 (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)
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)
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D002125
SnomedCT 387292008, 53691001
English Calcium Gluconate, Gluconate, Calcium, D-Gluconic acid, calcium salt (2:1), calcium gluconate, Calcium D-gluconate, calcium gluconate (medication), mineral supplements calcium gluconate, Calcium Gluconate [Chemical/Ingredient], Calcium gluconate, Calcium gluconate (product), Calcium gluconate (substance), CALGLUC, CALCIUM GLUCONATE
Swedish Kalciumglukonat
Czech glukonát vápenatý
Finnish Kalsiumglukonaatti
Russian KAL'TSIIA GLIUKONAT, КАЛЬЦИЯ ГЛЮКОНАТ
Japanese グルコン酸カルシウム
French Gluconate de calcium, Dextronate de calcium, Maltonate de calcium
Polish Glukonian wapniowy
Spanish gluconato de calcio (producto), gluconato de calcio (sustancia), gluconato de calcio, Gluconato de Calcio
German Calciumgluconat, Kalziumglukonat
Italian Gluconato di calcio
Portuguese Gluconato de Cálcio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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)
Concepts Pharmacologic Substance (T121) , Inorganic Chemical (T197)
MSH D002122
SnomedCT 387377009, 68395000
English Calcium Chloride, Chloride, Calcium, Calcium Chloride Hexahydrate, CALCIUM CHLORIDE, CALCIUM CHLORIDE ANHYDROUS, Calcium Chloride [Chemical/Ingredient], Anhydrous Calcium Chloride, Calcium Chloride, Anhydrous, Chloride, Anhydrous Calcium, calcium chloride, Calcium chloride, Calcium chloride (product), Calcium chloride (substance), Calcium Chloride Anhydrous
French Chlorure de calcium, CaCl2
Swedish Kalciumklorid
Czech chlorid vápenatý
Finnish Kalsiumkloridi
Russian KAL'TSIIA KHLORID, KAL'TSII KHLORISTYI, КАЛЬЦИЙ ХЛОРИСТЫЙ, КАЛЬЦИЯ ХЛОРИД
Japanese 塩化カルシウム
Italian Cloruro di calcio anidro, Cloruro di calcio
Polish Chlorek wapniowy, Wapnia chlorek
Spanish cloruro de calcio (producto), cloruro de calcio (sustancia), cloruro de calcio, Cloruro de Calcio
German Calciumchlorid, Kalziumchlorid
Portuguese Cloreto de Cálcio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Calcium gluceptate (C0108111)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH C007852
SnomedCT 71714008
English calcium gluceptate, calcium gluceptate (discontinued) (medication), mineral supplements calcium gluceptate (discontinued), calcium gluceptate (discontinued), Calcium Bis((2.xi.)-D-gluco-heptonate), Calcium Glucoheptonate (1:2), Calcium gluceptate, Calcium glucoheptonate, Calcium gluceptate (substance), calcium glucoheptonate, CALCIUM GLUCEPTATE, Calcium Gluceptate
Spanish gluceptato de calcio (sustancia), gluceptato de calcio, glucoheptonato de calcio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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