Calcium gluconate

Write your review

Calcium gluconate

• Quality

Title for your review^* Your review^* Your name^*

^* Required fields

Send

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

Overdosage

Studies and clinical trials of Calcium gluconate (Click to expand)