Diferencia entre revisiones de «Hypocalcemia»
Sin resumen de edición |
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| Línea 6: | Línea 6: | ||
**Corrected Ca = (0.8 * (Normal Alb - Pt's Alb)) + Serum Ca | **Corrected Ca = (0.8 * (Normal Alb - Pt's Alb)) + Serum Ca | ||
== | ==Clinical Features== | ||
#Paresthesias (mouth, fingertips) | #Paresthesias (mouth, fingertips) | ||
#Incr DTRs | #Incr DTRs | ||
| Línea 12: | Línea 12: | ||
#Weakness | #Weakness | ||
#Confusion | #Confusion | ||
# | #Seizurez | ||
#Chvostek/Trousseau | #Chvostek/Trousseau | ||
==Diagnosis== | |||
#ECG | #ECG | ||
##QT prolongation | ##QT prolongation | ||
| Línea 38: | Línea 40: | ||
==Treatment== | ==Treatment== | ||
*Be careful in | *Be careful in digoxin pts | ||
#Asymptomatic | #Asymptomatic | ||
##Calcium gluconate 1 gm PO Q6hrs | ##Calcium gluconate 1 gm PO Q6hrs | ||
| Línea 45: | Línea 46: | ||
#Symptomatic | #Symptomatic | ||
##Calcium gluconate/chloride 10mL of 10% soln IV over 10min | ##Calcium gluconate/chloride 10mL of 10% soln IV over 10min | ||
*Correct hypomag at same time (otherwise PTH is inhibited) | *Correct hypomag at same time (otherwise PTH is inhibited) | ||
==Source == | ==Source == | ||
*Tintinalli | |||
[[Category:FEN]] | [[Category:FEN]] | ||
Revisión del 20:44 2 mar 2012
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
Clinical Features
- Paresthesias (mouth, fingertips)
- Incr DTRs
- Cramps
- Weakness
- Confusion
- Seizurez
- Chvostek/Trousseau
Diagnosis
- 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 digoxin 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
- Tintinalli