Difference between revisions of "Calcium gluconate"

(Pharmacology: edited excretion)
 
(6 intermediate revisions by 4 users not shown)
Line 1: Line 1:
 
==General==
 
==General==
*Type:  
+
*Type: Electrolyte
*Dosage Forms: IV/PO
+
*Dosage Forms: injectable solution, tablet, capsule
*Common Trade Names: [[Calcium Gluconate]]
+
*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: 1000 mg/day PO (divided q8-12hr)
+
**19-50 years old: 1000mg/day PO (divided q8-12hr)
**>50 years old: 1200 mg/day PO (divided q8-12hr)
+
**>50 years old: 1200mg/day PO (divided q8-12hr)
**Pregnant or breastfeeding patient: 1000 mg/day PO (divided q8-12hr)
+
**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: 0.5 mg/kg/hr IV, may be increased to 2 mg/kg/hr
+
***without seizure or tetany: 0.5mg/kg/hr IV, may be increased to 2mg/kg/hr
 
***Hypocalcemic tetany:  
 
***Hypocalcemic tetany:  
****100-300 mg elemental calcium (~3g calcium gluconate) IV over 5-10 min  
+
****100-300mg elemental calcium (~3g calcium gluconate) IV over 5-10 min  
****Followed by continuous IV infusion at 0.5 mg/kg/hr
+
****Followed by continuous IV infusion at 0.5mg/kg/hr
 
+
*[[Calcium channel blocker toxicity]]: 3g IV (30-60mL of 10% soln)
 +
*[[Hyperkalemia]]: Give 10ml of a 10% solution over 10 mins
 
==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]]: [[Class C]]
+
*[[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:
**Adult
+
**CrCl less than 25 mL/min, base dosing on serum calcium levels
**Pediatric
+
**ESRD: if on HD, may need dose reduction
*Hepatic Dosing
+
*Hepatic Dosing: No adjustment
**Adult
 
**Pediatric
 
 
 
 
==Contraindications==
 
==Contraindications==
 
*Hypersensitivity  
 
*Hypersensitivity  
 
*Hypercalcemia
 
*Hypercalcemia
*Digoxin poisoning
+
*Ventricular fibrillation
 
+
*Digoxin toxicity (known or suspected)
 +
*Neonates receiving ceftriaxone sodium injection
 
==Adverse Reactions==
 
==Adverse Reactions==
*Frequency not defined
+
===Serious===
*Bradycardia
+
*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 56:
 
**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: Feces (80%), Urine (20%)
+
*Excretion: feces as unabsorbed calcium salt (80%), urine (20%)
*Mechanism of Action: Bone mineral component; cofactor in enzymatic reactions, essential for neurotrasmission, muscle contraction, and many signal transduction pathways.  
+
 
 +
==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:Drugs]]
+
[[Category:Pharmacology]]

Latest revision as of 00:13, 12 October 2017

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
  • Calcium channel blocker toxicity: 3g IV (30-60mL of 10% soln)
  • Hyperkalemia: Give 10ml of a 10% solution over 10 mins

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