Yes

Calcium Salt

Treatment of cardiac disturbances of hyperkalemia, hypocalcemia, or calcium channel blocker toxicity; cardiac resuscitation when epinephrine fails to improve myocardial contractions; treatment of hypermagnesemia and hypocalcemia

C

In ventricular fibrillation during cardiac resuscitation; patients with risk of digitalis toxicity, renal or cardiac disease; hypercalcemia

Avoid too rapid I.V. administration; avoid extravasation; use with caution in digitalized patients, respiratory failure or acidosis; metabolic acidosis (administer for only 2-3 days then change to another calcium salt)

<1%: Vasodilation, hypotension, bradycardia, cardiac arrhythmias, ventricular fibrillation, syncope, lethargy, mania, coma, erythema, hypomagnesemia, hypercalcemia, elevated serum amylase, tissue necrosis, muscle weakness, hypercalciuria

Symptoms of overdose include lethargy, nausea, vomiting, coma

Following withdrawal of the drug, treatment consists of bed rest, liberal intake of fluids, reduced calcium intake, and cathartic administration. Severe hypercalcemia requires I.V. hydration and forced diuresis. Urine output should be monitored and maintained at >3 mL/kg/hour. I.V. saline and natriuretic agents (eg, furosemide) can quickly and significantly increase excretion of calcium.

Decreased effect: Calcium may antagonize the effects of calcium channel blockers, atenolol, and sodium polystyrene sulfonate

Increased toxicity: Administer cautiously to a digitalized patient, may precipitate arrhythmias; hypercalcemia induced by thiazides may be increased with calcium administration

Admixture incompatibilities include carbonates, phosphates, sulfates, tartrates

Moderates nerve and muscle performance via action potential excitation threshold regulation

Absorption: I.M. and I.V. calcium salts are absorbed directly into the bloodstream

Distribution: Crosses the placenta; appears in breast milk

Elimination: Mainly in feces as unabsorbed calcium with 20% eliminated by the kidneys

Dose expressed in mg of calcium gluceptate (elemental calcium is in parentheses)

Children: 110 mg (9 mg Ca⁺⁺)/kg/dose

Adults: 1.1-1.5 g (90-123 mg Ca⁺⁺)

Hypocalcemia:

I.M.:

Children: 200-500 mg (16.4-41 mg Ca⁺⁺)/kg/day divided every 6 hours

Adults: 500 mg to 1.1 g/dose as needed

I.V.: Adults: 1.1-4.4 g (90-360 mg Ca⁺⁺) administered slowly as needed ( less than or equal to 2 mL/minute)

After citrated blood administration: Children and Adults: I.V.: 0.45 mEq Ca⁺⁺/100 mL blood infused

Dosing adjustment in renal impairment: Cl_cr <25 mL/minute: Dosage adjustments may be necessary depending on the serum calcium levels

Rapid I.V. injection at a maximum rate of 50 mg/minute; for I.V. infusion, dilute to a maximum concentration of 55 mg/mL and infuse over 1 hour or no greater than 150-300 mg/kg/hour (0.6-1.2 mEq calcium/kg/hour)

Serum calcium: 8.4-10.2 mg/dL

Due to a poor correlation between the serum ionized calcium (free) and total serum calcium, particularly in states of low albumin or acid/base imbalances, direct measurement of ionized calcium is recommended

In low albumin states, the corrected total serum calcium may be estimated by this equation (assuming a normal albumin of 4 g/dL)

Corrected total calcium = total serum calcium + 0.8 (4.0 - measured serum albumin)

or

Corrected calcium = measured calcium - measured albumin + 4.0

calcium (S); magnesium

No information available to require special precautions

No effects or complications reported

Warm to body temperature; administer slowly, do not exceed 2 mL/minute

Elemental calcium listed in brackets