Precautions
Take calcium gluconate oral with plenty of water. Calcium gluconate injection is given as an infusion into a vein. A healthcare provider will give you this injection. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when this medicine is injected.
How do you administer calcium gluconate?
can I give calcium gluconate IV push? Yes, Calcium Gluconate can be administered via a bolus (i.e. "push") dose or via continuous infusion: In general, dilute the dose to a concentration of 10-50 mg/mL in 5% dextrose or normal saline prior to administration.
Can I give calcium gluconate IV push?
Tetany: (Dose expressed in mg of calcium gluconate): IV: 100 to 200 mg/kg/dose over 5 to 10 minutes; may repeat after 6 hours or follow with an infusion with a maximum dose of 500 mg/kg/day. Dosing: Usual. Adequate intake (AI): (Dosage is in terms of elemental calcium):
How many mg of calcium gluconate can you take in a day?
Calcium Gluconate Injection Description. Calcium Gluconate in Sodium Chloride Injection is a sterile, preservative-free, nonpyrogenic solution of calcium gluconate, a form of calcium, for intravenous use. Calcium Gluconate is calcium D-gluconate (1:2) monohydrate. The structural formula is:
What is the formula for calcium gluconate injection?
How do you give calcium gluconate IV push?
When injected intravenously, calcium gluconate should be injected through a small needle into a large vein in order to avoid too rapid increase in serum calcium and extravasation of calcium solution into the surrounding tissue with resultant necrosis.
How do you infuse calcium gluconate IV?
10 to 20 mL of 10% calcium gluconate diluted in 50 to 100 mL dextrose or normal saline intravenously over 10 minutes is recommended. [14] For persistent symptoms, the bolus can be repeated after 10 to 60 minutes until symptoms resolve. After this, follow the steps for moderate to severe hypocalcemia.
Does calcium gluconate need to be diluted?
To avoid adverse reactions that may follow rapid intravenous administration, Calcium Gluconate Injection should be diluted with 5% dextrose or normal saline and infused slowly.
How do you administer calcium?
Take calcium gluconate oral with plenty of water. Calcium gluconate injection is given as an infusion into a vein. A healthcare provider will give you this injection. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when this medicine is injected.
How fast can you push IV calcium gluconate?
Maximum IV rate: 1.5 ml/min or approximately 1 gram/ 7 minutes. Too rapid injection may decrease blood pressure or cause cardiac syncope. Calcium administration: (Onset: rapid Duration: 30min to 2 hours. ). Recommended only in cases of hyperkalemia, hypocalcemia, or calcium antagonist blockade.
Why should IV calcium be given slowly?
Intravenous calcium chloride must be administered slowly via a small needle into a large vein, at a rate not exceeding 0.35 – 0.7 mmol per minute, to avoid venous damage and to prevent a high concentration of calcium reaching the heart and causing syncope.
How do you dilute calcium gluconate?
Calcium Gluconate Injection can be diluted with glucose 5% or sodium chloride 0.9%. Dilution into a solution containing bicarbonate, phosphate or sulfate should be avoided.
What is IV calcium gluconate used for?
Calcium gluconate is the calcium salt of gluconic acid, an intravenous medication used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hypoparathyrodism, and hypocalcemia due to rapid growth or pregnancy.
How much does 1 gram calcium gluconate raise calcium?
As a guideline, the total calcium will increase by 0.5 mg/dl for every gram of calcium gluconate given intravenously. MAXIMUM CONCENTRATIONS: Calcium gluconate: 1 gm in 50 ml D5W or NS.
Can calcium gluconate injection be given orally?
Take calcium gluconate oral with plenty of water. Calcium gluconate injection is given as an infusion into a vein. A healthcare provider will give you this injection.
Does IV calcium increase blood pressure?
Cardiovascular Pharmacology An intravenous bolus dose of calcium chloride of 5 mg/kg (or 0.035 mmol/kg) increases blood pressure but has little effect on myocardial contractility.
Why do we need to give calcium gluconate after blood transfusion?
Calcium levels can be significantly decreased with rapidly transfused blood products due to the citrate preservative that is added. Citrate binds to the patient's endogenous calcium when blood products are administered, rendering calcium inactive. As a result, undesirable physiological effects can occur.
How do you dilute calcium gluconate?
Calcium Gluconate Injection can be diluted with glucose 5% or sodium chloride 0.9%. Dilution into a solution containing bicarbonate, phosphate or sulfate should be avoided.
How do you make a calcium gluconate injection?
Draw up 4.5 mL (1.0 mmol) and add 5.5 mL of sodium chloride 0.9%, glucose 5% or glucose 10% to make a final volume of 10 mL with a concentration of 0.1 mmol/mL. Infuse dose over 10−60 minutes via a central line (if possible). Infuse undiluted over 5 – 10 minutes via a central line (if possible).
What is calcium gluconate IV used for?
Calcium gluconate is the calcium salt of gluconic acid, an intravenous medication used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hypoparathyrodism, and hypocalcemia due to rapid growth or pregnancy.
Can calcium gluconate be given peripherally?
Also, calcium gluconate is better tolerated through a peripheral IV. However, you recall that calcium gluconate might possess a slower onset of action because it requires hepatic metabolism to release the elemental and active form of calcium.
What Is Calcium Gluconate?
Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and ma...
Before Taking This Medicine
Ask a doctor or pharmacist if it is safe for you to take this medicine if you have ever had: 1. kidney disease; 2. kidney stones; 3. cancer; 4. a p...
How Should I Take Calcium Gluconate?
Use calcium gluconate exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than...
What Happens If I Miss A Dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to...
What Should I Avoid While Taking Calcium Gluconate?
Follow your healthcare provider's instructions about any restrictions on food, beverages, or activity.
Calcium Gluconate Side Effects
Get emergency medical help if you have signs of an allergic reaction to calcium gluconate: hives; difficulty breathing; swelling of your face, lips...
Calcium Gluconate Dosing Information
Usual Adult Dose for Hypocalcemia:Intravenous:500 to 2000 mg (5 to 20 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. The dose may be incr...
What Other Drugs Will Affect Calcium Gluconate?
Calcium can make it harder for your body to absorb certain medicines. If you take other medications, take them at least 2 hours before or 4 or 6 ho...
What is calcium gluconate?
Calcium is a mineral that is found naturally in foods. Calcium is necessary for many normal functions of the body, especially bone formation and maintenance.
How long after taking calcium gluconate can you take other medications?
Calcium can make it harder for your body to absorb certain medicines. If you take other medications, take them at least 2 hours before or 4 or 6 hours after you take calcium gluconate.
What are the side effects of calcium gluconate?
Common calcium gluconate side effects may include: warmth, tingling, or a heavy feeling; a chalky taste in your mouth; upset stomach, gas; or. constipation. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
What happens if you are allergic to calcium gluconate?
Get emergency medical help if you have signs of an allergic reaction to calcium gluconate: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
What is digoxin gluconate?
digoxin (digitalis); an antibiotic; or. other forms of calcium. This list is not complete and many other drugs may interact with calcium gluconate. This includes prescription and over-the-counter medicines, vitamins, and herbal products.
Can you take calcium gluconate with food?
Calcium can make it harder for your body to absorb certain medicines. Calcium gluconate works best if you take it with food. Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.
How much sulfate is in a day?
1000 to 1500 mg/day orally in divided doses.
Usual Adult Dose for Hypocalcemia
Initial dose: 1000 to 2000 mg intravenously (IV) Subsequent doses (as needed): -IV bolus: 1000 to 2000 mg every 6 hours -Continuous IV infusion: Initiate at 5.4 to 21.5 mg/kg/hour Maximum IV bolus infusion rate: 200 mg/min Comments: -Adjust dose based on symptom severity, serum calcium level, and acuity of hypocalcemia onset. -The safety of long term intravenous use has not been established. -The injectable product contains 100 mg calcium gluconate per mL, equal to 9.3 mg (0.465 mEq) elemental calcium. Use: Acute symptomatic hypocalcemia.
Usual Adult Dose for Hyperkalemia
The National Kidney Foundation recommends: 6.8 mmol calcium (30 mL of calcium gluconate 10% solution) intravenously for membrane potential stabilization
Usual Geriatric Dose for Dietary Supplement
Recommended Dietary Allowance (RDA) for elemental calcium: 51 to 70 years, male: 1000 mg 51 to 70 years, female: 1200 mg 71 years and older:1200 mg Tolerable Upper Intake Level (UL) for elemental calcium: 2000 mg
Usual Pediatric Dose for Hypocalcemia
Under 1 month: Initial dose: 100 to 200 mg/kg intravenously (IV) Subsequent doses (as needed): -IV bolus: 100 to 200 mg/kg every 6 hours -Continuous IV infusion: Initiate at 17 to 33 mg/kg/hour Maximum IV bolus infusion rate: 100 mg/min 1 month to under 17 years: Initial dose: 29 to 60 mg/kg intravenously (IV) Subsequent doses (as needed): -IV bolus: 29 to 60 mg/kg every 6 hours -Continuous IV infusion: Initiate at 8 to 13 mg/kg/hour Maximum IV bolus infusion rate: 100 mg/min Comments: -Adjust dose based on symptom severity, serum calcium level, and acuity of hypocalcemia onset. -The safety of long term intravenous use has not been established. -The injectable product contains 100 mg calcium gluconate per mL, equal to 9.3 mg (0.465 mEq) elemental calcium. Use: Acute symptomatic hypocalcemia.
Renal Dose Adjustments
Use with caution. -Initiate at the lowest recommended dose for the age; measure serum calcium every 4 hours during intravenous administration.
Precautions
CONTRAINDICATIONS: -Hypercalcemia -Neonates (28 days or younger) receiving ceftriaxone Consult WARNINGS section for additional precautions.
Other Comments
Administration advice: -Administer intravenous (IV) solution via a secure line to avoid calcinosis cutis and extravasation. -The IV solution should be clear and colorless to slightly yellow; do not use if cloudy or discolored. -Bolus IV administration: Dilute dose to a 10 to 50 mg/mL concentration; administer slowly (max 200 mg/min in adults and 100 mg/min in children); monitor patient, vitals, and electrocardiograph (ECG) during administration: -Continuous IV infusion: Dilute dose to a 5.8 to 10 mg/mL concentration; administer at correct rate for age; monitor patient, vitals, and ECG during administration. Reconstitution/preparation techniques: -Dilute IV solution in 5% dextrose or 0.9% sodium chloride. -Use diluted solution immediately after preparation. IV compatibility: -Incompatible with ceftriaxone; ceftriaxone-calcium precipitates may occur. -Incompatible with fluids containing bicarbonate or phosphate; precipitation may occur. -Incompatible with minocycline; calcium complexes minocycline, inactivating it. Monitoring: -Measure serum calcium every 1 to 4 hours during intravenous administration..
What is calcium gluconate in sodium chloride injection?
Calcium Gluconate in Sodium Chloride Injection is indicated for pediatric and adult patients for the treatment of acute symptomatic hypocalcemia.
How much calcium gluconate is in sodium chloride?
Calcium Gluconate in Sodium Chloride Injection contains 20 mg of calcium gluconate per mL which contains 1.86 mg (i.e., 0.093 mEq) of elemental calcium. See Table 1 for amounts of elemental calcium in Calcium Gluconate in Sodium Chloride Injection.
What are the symptoms of hypercalcemia?
Symptoms of hypercalcemia typically develop when the total serum calcium concentration is ≥12 mg/dL. Neurologic symptoms include depression, weakness, fatigue, and confusion at lower levels, with patients experiencing hallucinations, disorientation, hypotonicity, seizures, and coma.
Can calcium gluconate be injected with sodium chloride?
Rapid injection of Calcium Gluconate in Sodium Chloride Injection may cause vasodilation, decreased blood pressure, bradycardia, cardiac arrhythmias, syncope and cardiac arrest. To avoid adverse reactions that may follow rapid intravenous administration, Calcium Gluconate in Sodium Chloride Injection should be infused slowly. If rapid intravenous bolus of Calcium Gluconate Injection is required, the rate of intravenous administration should not exceed 200 mg/minute in adults and 100 mg/minute in pediatric patients and ECG monitoring during administration is recommended [see Dosage and Administration ( 2.1 )].
Is calcium gluconate toxic?
Calcium Gluconate in Sodium Chloride Injection contains alu minum, up to 25 mcg per liter, that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 mcg/kg/day to 5 mcg/kg/day accumulate aluminum levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.
Can you take ceftriaxone and calcium gluconate together?
In patients older than 28 days of age, ceftriaxone and Calcium Gluconate in Sodium Chloride Injection may be administered sequentially, provided the infusion lines are thoroughly flushed between infusions with a compatible fluid. Do not administer Ceftriaxone simultaneously with Calcium Gluconate in Sodium Chloride Injection via a Y-site in any age group.
Can calcium gluconate cause calcinosis?
Intravenous administration of Calcium Gluconate in Sodium Chloride Injection and local trauma may result in calcinosis cutis due to transient increase in local calcium concentration. Calcinosis cutis can occur with or without extravasation of Calcium Gluconate in Sodium Chloride Injection, is characterized by abnormal dermal deposits of calcium salts, and clinically manifests as papules, plaques, or nodules that may be associated with erythema, swelling, or induration. Tissue necrosis, ulceration, and secondary infection are the most serious complications.
How to administer calcium gluconate?
Calcium Gluconate should be administered intravenously either directly or by infusion. The dose is dependent upon the individual requirements of the patient. Calcium Gluconate may also be administered by intermittent infusion at a rate not exceeding 200 mg/min, or by continuous infusion.
What is calcium gluconate?
Calcium Gluconate belongs to a class of drugs called Antidotes, Other; Calcium Salts.
What are the side effects of calcium gluconate?
The most common side effects of Calcium Gluconate include: warmth, tingling, or heavy feeling, chalky taste in your mouth, upset stomach, gas, and. constipation.
How to report calcium gluconate side effects?
Tell the doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Calcium Gluconate. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
When injected intravenously, should calcium gluconate be injected through a small needle into a?
When injected intravenously, calcium gluconate should be injected through a small needle into a large vein in order to avoid too rapid increase in serum calcium and extravasation of calcium solution into the surrounding tissue with resultant necrosis.
What is the role of calcium in the body?
Calcium is the fifth most abundant element in the body and is essential for maintenance of the functional integrity of nervous, muscular and skeletal systems and cell membrane and capillary permeability . It is also an important activator in many enzymatic reactions and is essential to a number of physiologic processes including transmission of nerve impulses; contraction of cardiac, smooth and skeletal muscles; renal function; respiration and blood coagulation. Calcium also plays regulatory roles in the release and storage of neurotransmitters and hormones, in the uptake and binding of amino acids, and in cyanocobalamin (vitamin B 12) absorption and gastrin secretion.
Can you get calcium salts in a digitalized patient?
Because of the danger involved in simultaneous use of calcium salts and drugs of the digitalis group, a digitalized patient should not receive an intravenous injection of a calcium compound unless indications are clearly defined.
How much calcium gluconate is in 5% dextrose?
In general, Calcium Gluconate is diluted in 5% dextrose or normal saline to a concentration of 5.8-10 mg/mL.
Can you take calcium gluconate with a bolus?
Answer. Yes, Calcium Gluconate can be administered via a bolus (i.e. "push") dose or via continuous infusion: In general, dilute the dose to a concentration of 10-50 mg/mL in 5% dextrose or normal saline prior to administration. Administer the dose slowly.
How does insulin help with hyperkalemia?
Insulin remains one of the cornerstones of early severe hyperkalemia management. Insulin works via a complex process to temporarily shift potassium intracellularly. Though insulin certainly lowers plasma potassium concentrations, we often underestimate the hypoglycemic potential of a 10 unit IV insulin dose in this setting. The purpose of this post is to highlight the need for proper supplemental glucose and blood glucose monitoring when treating hyperkalemia with insulin. Incidence of Hypoglycemia One of my favorite articles on the management of hyperkalemia was written by Dr. Weisberg in Critical Care Medicine.1 A 10 unit dose of IV regular insulin has an onset of action of about 5-10 minutes, peaks at 25-30 minutes, and lasts 2-3 hours (the Weisberg article actually lists subcutaneous kinetics). Herein lies the problem in that IV dextrose only lasts about an hour (at most). Allon et al reported up to 75% of hemodialysis patients with hyperkalemia developed hypoglycemia at 60 minutes after insulin administration.2 A retrospective review of 219 hyperkalemic patients reported an 8.7% incidence of hypoglycemia after insulin treatment.3 More than half of the hypoglycemic episodes occurred with the commonly used regimen of 10 units of IV insulin with 25 gm of dextrose. A more recent study of 221 end-stage renal disease patients who received insulin for treatment of hyperkalemia reported a 13% incidence of hypoglycemia.4 The overall incidence of hypoglycemia appears to be ~10%, but could be higher. Risk Factors for Developing Hypoglycemia The study by Apel et al identified three factors associated with a higher risk of developing hypoglycemia: No prior diagnosis of diabetes [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.0–5.1, P = 0.05] No use of diabetes medication Continue reading >>
What is the best way to remove potassium from the body?
One example of a diuretic which does not spare potassium is furosemide. Resins like Kayexalate can also be used to remove potassium from the body.
How is hyperkalemia managed?
Critical Care Units (CCU) are equipped with electrolyte analyzers, which enable quick diagnosis of electrolyte status, and electrocardiogram (ECG) and cardiac monitors to recognize ECG changes that occur with hyperkalemia, helping to detect life-threatening arrhythmias. Hyperkalemia has always demanded extremely prompt intervention through different pharmacotherapeutic measures. The management of “acute hyperkalemia” with pharmacologic interventions has remained more or less the same over a long period where a variety of agents (drugs) are primarily directed at combating the acute crisis. Further objectives involve the prevention of hyperkalemia recurrence with novel drugs for chronic use. We never come across “chronic hyperkalemia” as no one can survive with persistent mild, moderate or severe hyperkalemia with continued serum potassium values above 5.5 mmol/l. Two novel oral therapies are in development for both acute and extended use in the management of hyperkalemia, sodium zirconium cyclosilicate and patiromer sorbitex calcium [1,2]. These promising new drugs have yet to be introduced into regular use for the treatment of hyperkalemia. One of these two molecules may be very useful in both acute situations as well as for chronic management, maintaining normokalemic status. We have also witnessed an increased incidence of hyperkalemia since the introduction of angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), aldosterone antagonists (AAs). These are increasingly used, either singularly or in varying combinations, for congestive heart failure (CHF), hypertension (HTN), diabet Continue reading >>
How long does it take to infuse insulin?
Add 10 units of neutral soluble insulin (Human Actrapid) to 50ml of glucose 50% and infuse over 15 minutes, preferably via a large vein (monitoring for signs of thrombophlebitis). This should lower plasma K + after 30 minutes by approximately 1 mmol/L, for approximately 2 hours.
