Calcium Booster!

Calcium Booster Cont’ Thanks for all of you for the excellent comments Calcium have many indication including the following and doses are depending on indication : 1. Symptomatic hypocalcemia resulting from intoxication by fluoride , oxalate ( ethylene glycol)or the IV anticoagulant citrate : give 20-30 ml of 10% calcium gluconate and repeat if needed 2. Hydrofluoric acid exposure : depending on route of exposure , for details ,see reference 3. Hypotension in the setting of calcium channel blocker overdose: start with 20-30 ml and going to higher dosage to reach 1.5 to 2 times the normal calcium level , administer calcium as 1 gram every 10-20 minutes or as continuous infusion 20-50 mg /kg /hr , serum calcium level should be measures every 2 hours with high dose calcium therapy 4. Severe hyperkalemia with cardiac manifestation: ve 20-30 ml of 10% calcium gluconate and repeat if needed 5. Symptomatic hypermagnesemia ;as above A 10 % solution of calcium chloride contain 3 times the amount of calcium than the 10% of calcium gluconate but need central line or big peripheral line due to risk of extravasation and tissue necrosis and it can not be used intradermal , subcutaneous or intra-arterial due the risk of tissue necrosis and damage Reference : 1. Olsen ‘s Poisoning and Drug Overdose , 6th edition