Calcium gluconate: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: Electrolyte | ||
*Dosage Forms: | *Dosage Forms: injectable solution, tablet, capsule | ||
*Common Trade Names: | *Dosage Strenths: injectable solution: 100mg/mL; tablet: 50, 500, 650mg; capsule: 500mg | ||
*Routes of Administration: PO, IV | |||
*Common Trade Names: | |||
==Adult Dosing== | ==Adult Dosing== | ||
*Calcium Supplementation | *Calcium Supplementation | ||
**19-50 years old: | **19-50 years old: 1000mg/day PO (divided q8-12hr) | ||
**>50 years old: | **>50 years old: 1200mg/day PO (divided q8-12hr) | ||
**Pregnant or breastfeeding patient: | **Pregnant or breastfeeding patient: 1000mg/day PO (divided q8-12hr) | ||
*[[Hypocalcemia]] | *[[Hypocalcemia]] | ||
**Mild (Calcium 1-1.2 mmol/L) | **Mild (Calcium 1-1.2 mmol/L) | ||
| Line 14: | Line 16: | ||
***1-2 g IV over 2 hours | ***1-2 g IV over 2 hours | ||
**Severe (Calcium < 1 mmol/L) | **Severe (Calcium < 1 mmol/L) | ||
***without seizure or tetany: 0. | ***without seizure or tetany: 0.5mg/kg/hr IV, may be increased to 2mg/kg/hr | ||
***Hypocalcemic tetany: | ***Hypocalcemic tetany: | ||
****100- | ****100-300mg elemental calcium (~3g calcium gluconate) IV over 5-10 min | ||
****Followed by continuous IV infusion at 0. | ****Followed by continuous IV infusion at 0.5mg/kg/hr | ||
*[[Calcium channel blocker toxicity]]: 3g IV (30-60mL of 10% soln) | |||
*[[Beta blocker toxicity]]: 3g IV (30-60mL of 10% soln) | |||
*[[Hyperkalemia]]: Give 10ml of a 10% solution over 10 mins | |||
*[[Hydrofluoric acid|Hydrofluoric acid toxicity]]:<ref>Su M. Hydrofluoric Acid. In: Goldfrank’s Toxicologic Emergencies, 10e. 2016.</ref> | |||
**25ml 10% calcium gluconate mixed with 75ml water soluble lubricant applied topically | |||
**In severe cases, can infuse 10ml 10% calcium gluconate mixed in 40mL of D5W through arterial catheter over 4 hours | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Hypocalcemia | |||
**Children: 200 to 500 mg IV (slow injection) | |||
**Infants: up to 200 mg IV (slow injection | |||
*Seizure due to hypocalcemia: 10% calcium gluconate IV 0.3 mL/kg over 5-10min | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[Lactation risk categories|Lactation risk]]: Use with caution | *[[Lactation risk categories|Lactation risk]]: Use with caution | ||
*Renal Dosing | *Renal Dosing: | ||
** | **CrCl less than 25 mL/min, base dosing on serum calcium levels | ||
** | **ESRD: if on HD, may need dose reduction | ||
*Hepatic Dosing | *Hepatic Dosing: No adjustment | ||
==Contraindications== | ==Contraindications== | ||
*Hypersensitivity | *Hypersensitivity | ||
*Hypercalcemia | *Hypercalcemia | ||
*Digoxin | *Ventricular fibrillation | ||
*Digoxin toxicity (known or suspected) | |||
*Neonates receiving ceftriaxone sodium injection | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
* | ===Serious=== | ||
* | *Bradycardia, vasodilation, hypotension, MI, cardiac arrest | ||
*Constipation | *Tissue necrosis (due to extravasation) | ||
*Urolithiasis | |||
*Prostate cancer | |||
===Common=== | |||
*Constipation, abdominal bloating, flatulence | |||
*Headache | *Headache | ||
| Line 48: | Line 61: | ||
**Absorption is increased with acidic condition; thus, administer 1-2 hr after meals | **Absorption is increased with acidic condition; thus, administer 1-2 hr after meals | ||
**~45% protein bound (primarily to albumin) | **~45% protein bound (primarily to albumin) | ||
*Excretion: | *Excretion: feces as unabsorbed calcium salt (80%), urine (20%) | ||
==Mechanism of Action== | |||
*Bone mineral component; cofactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways. | |||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Calcium chloride]] | |||
*[[Hypocalcemia]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] [[Category:FEN]] | ||
Latest revision as of 22:28, 29 November 2020
General
- Type: Electrolyte
- Dosage Forms: injectable solution, tablet, capsule
- Dosage Strenths: injectable solution: 100mg/mL; tablet: 50, 500, 650mg; capsule: 500mg
- Routes of Administration: PO, IV
- Common Trade Names:
Adult Dosing
- Calcium Supplementation
- 19-50 years old: 1000mg/day PO (divided q8-12hr)
- >50 years old: 1200mg/day PO (divided q8-12hr)
- Pregnant or breastfeeding patient: 1000mg/day PO (divided q8-12hr)
- Hypocalcemia
- Mild (Calcium 1-1.2 mmol/L)
- 1-3 g/day PO in divided doses
- 1-2 g IV over 2 hours
- Severe (Calcium < 1 mmol/L)
- without seizure or tetany: 0.5mg/kg/hr IV, may be increased to 2mg/kg/hr
- Hypocalcemic tetany:
- 100-300mg elemental calcium (~3g calcium gluconate) IV over 5-10 min
- Followed by continuous IV infusion at 0.5mg/kg/hr
- Mild (Calcium 1-1.2 mmol/L)
- Calcium channel blocker toxicity: 3g IV (30-60mL of 10% soln)
- Beta blocker toxicity: 3g IV (30-60mL of 10% soln)
- Hyperkalemia: Give 10ml of a 10% solution over 10 mins
- Hydrofluoric acid toxicity:[1]
- 25ml 10% calcium gluconate mixed with 75ml water soluble lubricant applied topically
- In severe cases, can infuse 10ml 10% calcium gluconate mixed in 40mL of D5W through arterial catheter over 4 hours
Pediatric Dosing
- Hypocalcemia
- Children: 200 to 500 mg IV (slow injection)
- Infants: up to 200 mg IV (slow injection
- Seizure due to hypocalcemia: 10% calcium gluconate IV 0.3 mL/kg over 5-10min
Special Populations
- Pregnancy Rating: C
- Lactation risk: Use with caution
- Renal Dosing:
- CrCl less than 25 mL/min, base dosing on serum calcium levels
- ESRD: if on HD, may need dose reduction
- Hepatic Dosing: No adjustment
Contraindications
- Hypersensitivity
- Hypercalcemia
- Ventricular fibrillation
- Digoxin toxicity (known or suspected)
- Neonates receiving ceftriaxone sodium injection
Adverse Reactions
Serious
- Bradycardia, vasodilation, hypotension, MI, cardiac arrest
- Tissue necrosis (due to extravasation)
- Urolithiasis
- Prostate cancer
Common
- Constipation, abdominal bloating, flatulence
- Headache
Pharmacology
- Half-life:
- Metabolism:
- Absorption requires Vitamin D
- Absorption is increased with acidic condition; thus, administer 1-2 hr after meals
- ~45% protein bound (primarily to albumin)
- Excretion: feces as unabsorbed calcium salt (80%), urine (20%)
Mechanism of Action
- Bone mineral component; cofactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways.
Comments
See Also
References
- ↑ Su M. Hydrofluoric Acid. In: Goldfrank’s Toxicologic Emergencies, 10e. 2016.