Generic Name:

Calcium

Trade Name:

Action:

Electrolyte Replacement

Indications:

HYPOCALCEMIA

Administration Guidelines:

Usual Dosage Range and Route:

- Calcium gluconate 1 g = 93 mg or 4.5 meq Ca++

- Calcium chloride 1 g = 273 mg or 13.5 meq Ca++

INITIAL DAILY DOSE : 1 - 2 gm / day

TOTAL DAILY DOSE: 10 - 12 gm /day. (Usually ordered by endocrine or thyroid consultants)

- Calcium Chloride (Centrally only, not as an IV Drip)

- Calcium Gluconate (Centrally OR Peripherally).

CALCIUM CHLORIDE MAY BE ADMINISTERED IV PUSH PERIPHERALLY IN EMERGENCY SITUATIONS

** INFUSE EACH DOSE OF CALCIUM GLUCONATE OVER 1 TO 2 HOURS **

** RECHECK CALCIUM LEVEL TWO HOURS POST-INFUSION **

Standard Concentrations:

Ca Gluconate     

 Central:
1 G / 10 ml

Peripheral: (Ca Gluconate only)
1 G /100 ml
2 G / 100 ml 
20 G/ 1000ml NS (CVVH)

Ca Chloride (not as an IV drip)

Central:
IVP OVER 5 mins for emergency situations

Peripheral:
N/A

EW Standards

Ca Gluconate     

 Central: 1 G / 10 ml
Peripheral: (Ca Gluconate only)
1 G / 100 ml
2 G / 100 ml  

Special Considerations:

- Patients on CVVH may require higher total daily doses

- Serum electrolyte levels should be known prior to therapy and monitored during calcium administration.

- Patients with hypo or hyper magnesemia may not respond to calcium repletion until magnesium disorder is corrected.

- Elevated serum calcium levels with normal digoxin levels can mimic signs and symptoms of digoxin toxicity.

- May worsen AV block in patients receiving calcium channel blockers.

Precautions and Side Effects:

- AV block, ventricular arrhythmias

- hypotension, bradycardia

- change in mental status

- elevated bun

- muscle flaccidity