calcium abnormalities Flashcards
1
Q
why should you look at the corrected calcium?
what are the non drug causes of hypocalcaemia?
A
- calcium is highly bound to plasma proteins
- renal failure
- hypoparathyroidism
- hyperphosphataemia
- hypomagnesaemia
- Vit D deficiency
2
Q
what are the drug causes of hypocalcaemia?
A
- aminoglycoside abx
- corticosteroids
- oral contraceptives
- phenytoin
3
Q
what are the symptoms of hypocalcaemia?
A
- tetany
- paraesthesia
- cramps
- anxiety
4
Q
what is the treatment for all hypocalcaemia?
what is the treatment for mild hypocalcaemia?
treatment for severe hypocalcaemia?
A
- check magnesium level and correct
- oral calcium (calcichew/ Sandocal)
- 10ml IV calcium gluconate 10% slowly over 10 mins
- continuous IV infusion of 40ml calcium gluconate 10% in 1 litre of NaCl 0.9% over 4-8 hours
- ECG monitoring
5
Q
what should you monitor in hypocalcaemia?
A
- daily serum corrected calcium
- renal function and electrolytes
- consider continuous cardiac monitoring if severe hypocalcaemia
- monitor patients on digoxin (IV calcium can increase toxicity)
6
Q
what is the non drug causes of hypercalcaemia?
drug cause?
A
- hyperparathyroidism
- malignant disease
- thyrotoxicosis
- Addisons
- renal failure
- thiazide diuretics
- vit D
- lithium treatment
7
Q
what are the symptoms of hypercalcaemia?
A
- bone pain
- renal colic
- n + v
- polyuria
- altered consciousness
- shortened QT interval
8
Q
what is the conservative treatment for hypercalcaemia?
mild/ moderate hypercalcaemia?
Severe hypercalcaemia? what is the concentration for severe?
A
- remove underlying cause
- restrict calcium intake
- correct hypokalaemia/ hypomagnesaemia
- rehydrate with 0.9% NaCl
- loop diuretics to enhance calcium excretion (furosemide)
- adequate rehydration with 0.9% NaCl, loop diuretics
- pamidronate IV infusion
9
Q
what should be monitored in hypercalcaemia?
A
- daily serum calcium conc
- renal function + electrolytes
- continuous cardiac monitoring if severe hypercalcaemia
