CALCIUM GLUCONATE

CLASSES:

• Electrolyte

• Positive inotropic agent

ACTIONS:

• Facilitates actin-myosin interaction in cardiac muscle and smooth muscle

• Establishes electrical gradient to move K+ from plasma to cell in hyperkalemia

INDICATIONS:

• Acute hyperkalemia in pts needing hemodialysis

• Hypotension from calcium channel blocker toxicity

• Hypocalcemia or Hyperphosphatemia

• Magnesium Sulfate overdose

• Possibly useful in some beta-blocker overdose

CONTRAINDICATIONS:

• Hypercalcemia

• Hypophosphatemia

• Digoxin Toxicity

• Ventricular Dysrhythmias

STANDARD PREP:

• 1 gram in 10 mL or 100 mg per mL (10%)

DOSAGE/ROUTE:

• See Hawaii S.O. for Renal Dialysis Cardiac Arrest = 1 gram IVP followed by saline flush. May repeat x1 if no effect

• In conscious patient, administer slowly ~ 1 ml/min

SIDE EFFECTS:

• Hypotension, nausea, flushing and diaphoresis

• May potentiate digoxin toxicity

• May cause ventricular standstill in beating heart

• Hypomagnesemia

• May cause pain or burning at IV site

• Hypercalcemia is associated with weakness, confusion, unresponsiveness, as well as other symptoms

PRECAUTIONS:

• Do not mix with sodium bicarbonate without flushing the line first since precipitate may form

• Hypocalcemia is associated with carpal-pedal spasm, tetany, seizures, Trousseau’s sign, Chvostek’s sign