Ver el código de «Calcium gluconate»

==General==
*Type: Electrolyte
*Dosage Forms: injectable solution, tablet, capsule
*Dosage Strenths: injectable solution: 100mg/mL; tablet: 50, 500, 650mg; capsule: 500mg
*Routes of Administration: PO, IV
*Common Trade Names: 

==Adult Dosing==
*Calcium Supplementation
**19-50 years old: 1000mg/day PO (divided q8-12hr)
**>50 years old: 1200mg/day PO (divided q8-12hr)
**Pregnant or breastfeeding patient: 1000mg/day PO (divided q8-12hr)
*[[Hypocalcemia]]
**Mild (Calcium 1-1.2 mmol/L)
***1-3 g/day PO in divided doses
***1-2 g IV over 2 hours
**Severe (Calcium < 1 mmol/L)
***without seizure or tetany: 0.5mg/kg/hr IV, may be increased to 2mg/kg/hr
***Hypocalcemic tetany: 
****100-300mg elemental calcium (~3g calcium gluconate) IV over 5-10 min 
****Followed by continuous IV infusion at 0.5mg/kg/hr
*[[Calcium channel blocker toxicity]]: 3g IV (30-60mL of 10% soln)
*[[Hyperkalemia]]: Give 10ml of a 10% solution over 10 mins
*[[Hydrofluoric acid|Hydrofluoric acid toxicity]]:<ref>Su M. Hydrofluoric Acid. In: Goldfrank’s Toxicologic Emergencies, 10e. 2016.</ref>
**25ml 10% calcium gluconate mixed with 75ml water soluble lubricant applied topically
**In severe cases, can infuse 10ml 10% calcium gluconate mixed in 40mL of D5W through arterial catheter over 4 hours

==Pediatric Dosing==
*Hypocalcemia
**Children: 200 to 500 mg IV (slow injection)
**Infants:  up to 200 mg IV (slow injection
*Seizure due to hypocalcemia: 10% calcium gluconate IV 0.3 mL/kg over 5-10min
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: Use with caution
*Renal Dosing: 
**CrCl less than 25 mL/min, base dosing on serum calcium levels
**ESRD: if on HD, may need dose reduction 
*Hepatic Dosing: No adjustment
==Contraindications==
*Hypersensitivity 
*Hypercalcemia
*Ventricular fibrillation
*Digoxin toxicity (known or suspected)
*Neonates receiving ceftriaxone sodium injection
==Adverse Reactions==
===Serious===
*Bradycardia, vasodilation, hypotension, MI, cardiac arrest
*Tissue necrosis (due to extravasation)
*Urolithiasis
*Prostate cancer
===Common===
*Constipation, abdominal bloating, flatulence
*Headache

==Pharmacology==
*Half-life: 
*Metabolism: 
**Absorption requires Vitamin D
**Absorption is increased with acidic condition; thus, administer 1-2 hr after meals
**~45% protein bound (primarily to albumin)
*Excretion: feces as unabsorbed calcium salt (80%), urine (20%)

==Mechanism of Action==
*Bone mineral component; cofactor in enzymatic reactions, essential for neurotransmission, muscle contraction, and many signal transduction pathways. 

==Comments==

==See Also==
*[[Calcium chloride]]
*[[Hypocalcemia]]
==References==
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[[Category:Pharmacology]] [[Category:FEN]]