Calcium Chloride 10%

Question 1

Generic Name:

Answer 1

Calcium Chloride 10%

Question 2

Class:

Answer 2

Electrolyte

Question 3

Mechanism of Action:

Answer 3

•  Increases extracellular and intracellular calcium levels
•  Stimulates release of catecholamines
•  Increases cardiac contractile state (positive inotropic effect)
•  May enhance ventricular automaticity
•  Inhibits the effects of adenosine on mast cells

Question 4

Indications and Field Use:

Answer 4

•  Acute hypocalcemia
•  Calcium channel blocker OD
•  Acute hyperkalemia (known or suspected)
•  Hypermagnesemia (Magnesium OD)
•  Pre-treatment for IV calcium channel blocker administration

Question 5

Contraindications:

Answer 5

• Hypercalcemia

- Concurrent digoxin therapy (relative)

Question 6

Adverse Reactions:

Answer 6

•  Brady-asystolic arrest
•  Severe tissue necrosis if solution extravasates
•  Use cautiously in patients on digitalis; may cause serious arrhythmias

Question 7

Incompatibilities/Drug Interactions:

Answer 7

All drugs – flush line before and after administration

Question 8

Adult Dosage: Hypocalcemia, calcium channel blocker OD, hyperkalemia and hypermagnesemia:

Answer 8

5-10 ml (0.5-1 Gm) of 10% calcium chloride. May repeat in 10 minutes.

Question 9

Adult Dosage: Pre-treatment for IV calcium channel blocker administration:

Answer 9

3 ml of 10% calcium chloride. May be repeated once.

Question 10

Pediatric Dosage: Hypocalcemia, calcium channel blocker OD hyperkalemia and hypermagnesemia:

Answer 10

0.2 - 0.25 ml/kg of a 10% solution infused slowly. Should not be repeated without documented calcium deficiency.

Question 11

Routes of Administration:

Answer 11

IV bolus

Question 12

Onset of Action:

Answer 12

Seconds

Question 13

Peak Effects:

Answer 13

3 - 5 minutes

Question 14

Duration of Action:

Answer 14

15 - 30 minutes

Question 15

Arizona Drug Box Minimum Supply:

Answer 15

1g

Question 16

Special Notes:

Answer 16

•  For pediatrics, calcium chloride may be diluted with 1-2 ml of NS IV fluid per ml calcium chloride.
•  Concurrent administration of sodium bicarbonate and calcium chloride will produce a precipitate, calcium carbonate (chalk).
•  Studies have shown no benefit from calcium administration in asystole or PEA. There is increasing evidence that calcium increases damage to cells that have been injured and worsens the neurological outcome.
•  Pediatric patients should not receive IV calcium channel blockers such as verapamil, therefore there is no dose for pre-treatment.
•  Use of calcium chloride in treatment of hyperkalemia is a part of a combination drug therapy (See profiles for dextrose and sodium bicarbonate). Insulin may be given upon arrival to ED.
•  Calcium chloride is not recommended in patients with suspected digitalis toxicity

Question 17

Supplied:

Answer 17

1g/10mL pre-filled syringe