Buy gluconate-SOLOpharmrastwordlya solution 100 mg/ml 10 ml ampoules 10 pcs
  • Buy gluconate-SOLOpharmrastwordlya solution 100 mg/ml 10 ml ampoules 10 pcs

Calcium gluconate

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2019-09-19
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Clinical Pharmacology

Pharmacotherapeutic group

Calcium-phosphorus metabolism regulator.

ATH code: A12AA03

Pharmacological properties

Pharmacodynamics

The calcium preparation compensates for the deficiency of calcium ions necessary for the implementation of the process of transmission of nerve impulses, reduction of skeletal and smooth muscles, myocardial activity, formation of bone tissue, blood coagulation.

When administered intravenously, it stimulates the sympathetic part of the autonomic nervous system, increases adrenaline secretion by the adrenal glands.

Pharmacokinetics

After parenteral administration of calcium, gluconate is evenly distributed with the blood stream in all tissues and organs. In blood plasma, calcium is found both in bound form (in combination with proteins and with anions of organic and inorganic acids (bicarbonate, phosphate, lactate, calcium citrate)), and in free ionized form. Penetrates through the placental barrier, passes into breast milk. Excreted mainly by the kidneys.

Indications

Treatment of acute hypocalcemia. To reduce capillary permeability in allergic conditions, non-thrombocytopenic purpura and exudative dermatoses, for example, herpetiform dermatitis and itchy rash due to the use of certain medications.

Composition

1 ml of the preparation contains:

Active substance:

Calcium gluconate monohydrate 94 mg

Excipients:

Calcium sugar 5 mg

Water for injection up to 1 ml

Calcium gluconate is marketed under different brands and generic names, and comes in different dosage forms:

Brand nameManufacturerCountryDosage form
gluconate-SOLOpharmrastwordlya solution
Calcium gluconate pills 0.5 g Pharmstandard Russia pills
Calcium gluconate Vial Russia ampoules
Calcium gluconate B. Brown Medical AG Germany solution
Calcium gluconate PFK Obnovlenie Russia pills

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Calcium gluconate

Dosage and Administration

Normally, the concentration of total calcium in serum is 2.25-2.75 mmol / l or 4.45-5.5 sEq / l. Therapy with calcium gluconate is aimed at restoring the normal concentration of calcium in the blood plasma. Solutions containing calcium should be administered slowly to minimize peripheral vasodilation and cardiac depression.

The drug before the introduction is heated to body temperature. The drug is injected deep intramuscularly or intravenously slowly (within 2-3 minutes), or drip, to exclude the possibility of local irritation or necrosis in the event of ingestion of the drug in perivascular tissue. Intravenous injections should be carried out under careful monitoring of heart rate and electrocardiogram, because if calcium gluconate is administered too quickly, bradycardia with vasodilation and arrhythmia may occur.

With intravenous administration, fever may be felt throughout the body, which passes quickly.

Because of the risk of local irritation, intramuscular injections should be performed only if intravenous injection is impossible. Intramuscular injections should be performed sufficiently deep into the muscle, preferably in the gluteal region. For obese patients, a longer needle should be chosen for safe insertion into the muscle and not into adipose tissue. If repeated injections are necessary, the injection site should be changed each time.

During treatment, it is necessary to carefully monitor the concentration of calcium in the blood plasma, and when administered in high doses, additionally control the rate of excretion of calcium in the urine.

Adults: deeply intramuscularly, intravenously slowly (within 2-3 minutes) or drip 5-10 ml of 100 mg / ml (10% solution) daily, every other day or after 2 days (depending on the nature of the disease and the patient's clinical condition). Subsequent doses are determined in accordance with the concentration of calcium in the serum.

Children under 18 years of age: the dose and route of administration depends on the degree of hypocalcemia, the nature and severity of symptoms.

For children, depending on age, the drug at a concentration of 100 mg / ml (10% solution) is administered in the following doses: up to 6 months - 0.1-1 ml; 7-12 months - 1-1.5 ml; 1-3 years -

1.5-2 ml; 4-6 years old - 2-2.5 ml; 7-14 years - 3.5 ml; over 14 years old - as for adults. Children can not be administered intramuscularly because of the possible development of necrosis. Only slow intravenous injection or intravenous infusion after dilution is recommended in order to achieve sufficiently low rates of administration and to exclude the possibility of local irritation or necrosis if the drug is accidentally injected into perivascular tissues.

For intravenous infusion, the drug is diluted in a ratio of 1:10 to a concentration of 10 mg / ml with the following solutions for infusion: 0.9% sodium chloride solution or 5% glucose solution. The rate of intravenous administration should not exceed 50 mg of calcium gluconate per minute. Thinning should be done under aseptic conditions.

Elderly patients: there is no data indicating adverse tolerance of calcium gluconate in elderly patients, however, age-related changes, such as renal dysfunction and slower metabolism, may require a dose reduction.

The procedure for working with polymer ampoule:

- Take the vial and shake it, holding it by the neck.

- Turn and separate the valve in a rotating motion.

- Through the formed hole immediately connect the luer syringe with the ampoule.

- Type in the syringe contents of the ampoule.

- Put the needle on the syringe.

Adverse reactions

The frequency of side effects is directly related to the rate of administration and the dose of calcium gluconate. With the correct introduction, the frequency of their occurrence is 1/1000.

Since the cardiovascular system: lower blood pressure, bradycardia, arrhythmia, vasodilation, circulatory collapse (including fatal), "tides" of blood, most often with a rapid introduction.

On the part of the digestive system: nausea, vomiting, diarrhea.

General disorders: feeling of warmth, sweating.

Violations at the injection site: for intramuscular injection - pain or erythema (≤ 1/10, ≥ 1/100), for violation of the intramuscular injection technique - infiltration into adipose tissue, followed by abscess formation, compaction of tissues and necrosis; when administered intravenously, skin hyperemia, burning sensation or pain with possible development of tissue necrosis (with an accidental perivascular injection).

It was reported about the case of calcification of soft tissues with subsequent possible skin lesions and necrosis due to the release of calcium from the vessel into the tissue.

Contraindications

Hypersensitivity to calcium gluconate and other components of the drug, hypercalcemia (including in patients with hyperparathyroidism, hypervitaminosis D, decalcifying malignant neoplasms, renal failure, osteoporosis associated with immobilization, sarcoidosis, milky-alkaline syndrome (Bertet syndrome) associated with the immobilization, sarcoidosis, milky-alkaline syndrome (Bertet syndrome), s) intoxication with cardiac glycosides, simultaneous treatment with cardiac glycosides; for intramuscular injection - children's age.

Carefully

Dehydration, electrolyte abnormalities (risk of hypercalcemia), diarrhea, malabsorption syndrome, calcium nephrourolithiasis (history), slight hypercalciuria, moderate chronic renal failure, advanced atherosclerosis, hypercoagulation, in older patients, especially in one or more children, with an increase of antestrophy, and in an adult with an adult with an increase of antestrophy; , cardiovascular pathology, sarcoidosis, chronic heart failure, simultaneous treatment with epinephrine. Before using the drug should consult a doctor.

Drug interactions

The syringe filled with calcium gluconate solution should not contain ethyl alcohol residues, since in the presence of the last calcium gluconate precipitates. Pharmaceutically incompatible with carbonates, salicylates, sulphates and ceftriaxone (forms insoluble or insoluble calcium salts with them). Forms insoluble complexes with tetracycline antibiotics, reducing the antibacterial effect.

Weakens the action of blockers of "slow" calcium channels (intravenous administration of calcium gluconate before or after taking verapamil reduces its hypotensive effect, but has little effect on its antiarrhythmic effect).

With simultaneous use with quinidine may slow intraventricular conductivity and increase the toxicity of quinidine.

The use of calcium gluconate during treatment with cardiac glycosides is not recommended (possibly increasing the cardiotoxic effect of cardiac glycosides). When combined with thiazide diuretics, it may increase hypercalcemia.

Reduces the effect of calcitonin with hypercalcemia.

Reduces the bioavailability of phenytoin.

Special instructions

The drug before the introduction is heated to body temperature. The drug is injected deep intramuscularly or intravenously slowly (within 2-3 minutes), or drip, to exclude the possibility of local irritation or necrosis in the event of ingestion of the drug in perivascular tissue. Intravenous injections should be carried out under careful monitoring of heart rate and electrocardiogram, because if calcium gluconate is administered too quickly, bradycardia with vasodilation and arrhythmia may occur.

With intravenous administration, fever may be felt throughout the body, which passes quickly.

Because of the risk of local irritation, intramuscular injections should be performed only if intravenous injection is impossible. Intramuscular injections should be performed sufficiently deep into the muscle, preferably in the gluteal region. For obese patients, a longer needle should be chosen for safe insertion into the muscle and not into adipose tissue.If repeated injections are necessary, the injection site should be changed each time.

During treatment, it is necessary to carefully monitor the concentration of calcium in the blood plasma, and when administered in high doses, additionally control the rate of excretion of calcium in the urine.

When intravenous calcium gluconate is administered, in exceptional cases, patients receiving cardiac glycosides need to control cardiac activity and conditions must be provided for the urgent treatment of heart complications (such as marked arrhythmias).

Calcium salts should be used with caution and only after careful determination of indications in patients with nephrocalcinosis, pathology of the cardiovascular system, sarcoidosis (Beck's disease), in patients receiving epinephrine, in elderly patients.

Impaired renal function may be associated with hypercalcemia and secondary hyperparathyroidism. Therefore, parenteral calcium should be administered to patients with impaired renal function only after a thorough determination of parameters, and the calcium-phosphate balance must be monitored.

With simultaneous use with other drugs requires medical supervision.

The solution should be used only if it is transparent and the ampoule is intact. Dilute the preparation immediately after opening the ampoule. When diluting the drug requires strict adherence to the rules of asepsis. In terms of microbiological safety, the diluted drug should be used immediately. Ampoule is for single use only. Exceptions are dilutions prepared under controlled aseptic conditions. After preparation of the solution, the terms and conditions of its storage prior to the introduction are the responsibility of the user and should not exceed 24 hours at a temperature of from 2 to 8 ° C. The remaining unused quantities of the drug to be destroyed.

Impact on the ability to drive trans. Wed and fur .:

During the period of drug treatment, care must be taken when performing potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions (driving, working with moving mechanisms, the work of the dispatcher and the operator).

Overdosage

Symptoms of hypercalcemia: anorexia, nausea, vomiting, constipation, abdominal pain, polyuria, polydipsia, dehydration, muscle weakness, bone pain, calcification of the kidneys, drowsiness, hypersomnia, confusion, increased blood pressure, in severe cases - arrhythmia (up to cardiac arrest) and coma.

Treatment: aims to reduce elevated plasma calcium levels. Initial therapy includes rehydration; in severe hypercalcemia, it may be necessary to administer a 0.9% sodium chloride intravenous infusion solution to increase the amount of extracellular fluid. Calcitonin may be used to reduce the serum calcium concentration.

Furosemide can be used to increase calcium excretion, but “thiazide” diuretics should not be used, since they can increase calcium absorption in the kidneys. Hemodialysis or peritoneal dialysis is carried out if other measures are not effective or if symptoms of hypercalcemia persist. Treatment of overdose is carried out under careful control of the concentration of electrolytes in the serum.

Studies and clinical trials of Calcium gluconate (Click to expand)
  1. Prevention of citrate reactions during therapeutic plasma exchange by constant infusion of calcium gluconate with the return fluid
  2. Corrosion inhibition of carbon steel in the near neutral media by blends of tannin and calcium gluconate
  3. The role of calcium gluconate in electrochemical activation of titanium for biomimetic coating of calcium phosphate
  4. Continuous infusion of calcium gluconate in 5% albumin is safe and prevents most hypocalcemic reactions during therapeutic plasma exchange
  5. Drug interactions I: Folic acid and calcium gluconate
  6. Determination of calcium gluconate by selective oxidation with periodate
  7. Solubilizing effects of calcium salts upon calcium gluconate
  8. Stable supersaturated solutions of calcium gluconate
  9. Solubilities of l-glutamic acid, 3-nitrobenzoic acid, p-toluic acid, calcium-l-lactate, calcium gluconate, magnesium-dl-aspartate, and magnesium-l-lactate in water
  10. Influence of calcium gluconate with calcium chloride or glucose on the hydration of cements
  11. A discussion of the paper “Influence of calcium gluconate with calcium chloride or glucose on the hydration of cements” by N.B. Singh
  12. Deactivation kinetics of immobilized glucose oxidase for production of calcium gluconate in an external loop airlift bioreactor
  13. Application of 2-factorial design on the enhanced production of calcium gluconate by a mutant strain of Aspergillus niger
  14. Diffusion of calcium gluconate in aqueous solutions of lactose at 298.15 K
  15. Solubilities of magnesium-l-ascorbate, calcium-l-ascorbate, magnesium-l-glutamate, magnesium-d-gluconate, calcium-d-gluconate, calcium-d-heptagluconate, l-aspartic acid, and 3-nitrobenzoic acid in water
  16. Degradation of calcium d-gluconate-2-d with alkaline hydrogen peroxide
  17. Optimal operation of an integrated bioreaction–crystallization process for continuous production of calcium gluconate using external loop airlift columns
  18. Regional Intravenous Infusion of Calcium Gluconate for Hydrofluoric Acid Burns of the Upper Extremity
  19. A kinetic study on air oxidation of glucose catalyzed by immobilized glucose oxidase for production of calcium gluconate
  20. A kinetic study on crystallization of calcium gluconate in external loop airlift column and stirred tank for an immobilized glucose oxidase reaction with crystallization
  21. Reduction of adverse citrate reactions during autologous large-volume PBPC apheresis by continuous infusion of calcium-gluconate
  22. Effects of Cation Interactions on Sugar Anion Conformation in Complexes of Lactobionate and Gluconate with Calcium, Sodium or Potassium
  23. Corrosion inhibition of ammonium molybdate for AA6061 alloy in NaCl solution and its synergistic effect with calcium gluconate
  24. Glucose oxidase-richAspergillus nigerstrain, cost-effective protocol and an economical substrate for the preparation of tablet grade calcium gluconate

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