Calcium

dr.joan

Calcium:
Trade name: Calciday, Caltrate
Class: Electrolyte, mineral Calcium Salts
Pregnancy: (Category

Action:
§ It is essential for maintenance of normal function of nerves, muscles, skeletal system & permeability of cell membranes & capillaries.
§ Necessary for activation of many enzymes, contraction of cardiac, skeletal & smooth muscles, never impulses, respiration, and blood coagulation.
Uses:
* I.V:
§ Acute hypocalcemic tetany secondary to :
§ Renal failure
§ Hypoparathyroidism.
§ Premature infants.
§ To treat depletion of electrolytes.
§ During cardiac resuscitation.
* I.M. or I.V:
· To reduce spasm (renal & intestinal).
· To relief sensitivity reactions of insect bites.

** P.O:
§ Chronic hypoparathyroidism.
§ Osteoporosis
§ Osteomalacia.
§ Rickets
§ Myasthenia gravis
§ Supplement for pregnant women.

Dose
§ In hypocalcaemic tetany an initial intravenous injection of 10 mL (2.25 mmol) of calcium gluconate injection 10% should be followed by the continuous infusion of about 40 mL (9 mmol) daily, but plasma calcium should be monitored.
§ This regimen can also be used immediately to temporarily reduce the toxic effects of hyperkalaemia.
§ Maintenance: calcium gluconate 1–2 g daily.

Contraindications:
· Digitized patients.
· Some renal & cardiac patients.
· Cancer with bone metastasis.
Side effects:
§ Hypercalceia characterized by lassitude – fatigue, skeletal muscle weakness, confusion & constipation.
§ Renal calculi, bradycardia, arrhythmias & renal impairment.
§ Rapid I.V. administration. May result in vasodilatation, decreased B.P. & H.R., cardiac arrhythmias, syncope and cardiac arrest.
Nursing considerations:
Oral:
· administer 1-1.5 hr after meals, alkalis & large amounts of fat
decrease the absorption of calcium.
· If the client has difficulty swallowing large tablets, obtain a calcium in water suspension by diluting the calcium in hot water then cooled by administration.
I.V:
· Administer slowly.
· Observe vital signs closely for evidence of bradycardia & hypotension.
· Prevent any leakage of medication into the tissue since it is extremely irritating.
I.M:
· Rotate the injection sites.
· Obtain baseline renal function.
· In case of hypocalcemic tetany, provide safety precautions to prevent injury.