Diferencia entre revisiones de «Hypocalcemia»
| Línea 38: | Línea 38: | ||
==Treatment== | ==Treatment== | ||
*Be careful in dig pts | |||
#Asymptomatic | #Asymptomatic | ||
## | ##Calcium gluconate 1 gm PO Q6hrs | ||
## | ##Vitamin D (calcitriol) 0.2 mcg BID | ||
#Symptomatic | #Symptomatic | ||
## | ##Calcium gluconate/chloride 10mL of 10% soln IV over 10min | ||
#Correct hypomag at same time (otherwise PTH is inhibited) | |||
==Source == | ==Source == | ||
Revisión del 05:14 4 may 2011
Background
- Low <8.5 (<2.0 ionized)
- Low! <6.5 (<1.5 ionized)
- Correct for hypoalbumimia
- Corrected Ca = (0.8 * (Normal Alb - Pt's Alb)) + Serum Ca
Diagnosis
- Paresthesias (mouth, fingertips)
- Incr DTRs
- Cramps
- Weakness
- Confusion
- Sz
- Chvostek/Trousseau
- ECG
- QT prolongation
DDX
- Misc
- Shock
- Sepsis
- Pancreatitis
- Hypomag
- Rhabdo (phosphate overload)
- Decreased absorption
- Vit D def
- Increased excretion
- Alcoholism
- Renal failure
- Diuretics
- Endocrine
- Hypoparathyroidism
- Drugs
- Cimetidine
- Phenytoin
- Lasix
Treatment
- Be careful in dig pts
- Asymptomatic
- Calcium gluconate 1 gm PO Q6hrs
- Vitamin D (calcitriol) 0.2 mcg BID
- Symptomatic
- Calcium gluconate/chloride 10mL of 10% soln IV over 10min
- Correct hypomag at same time (otherwise PTH is inhibited)
Source
2/12/06 DONALDSON (adapted from Tintinalli)