Calcium Gluconate 10%

Question 1

Calcium - Drug Class/Presentation

Answer 1

Electrolyte, 1g/10mL

Question 2

Calcium - Pharmacology

Answer 2

Calcium plays an integral role in the muscular and neural systems. It is involved in skeletal muscle contraction, excitation couple in cardiac and smooth muscle and acts as an intracellular 2nd messenger. These effects combine to exert a positive inotropic effect in the post cardiac arrest patient. It additionally has a role in cardiac membrane stabilisation in hyperkalaemia and as an effective treatment of pain an systemic symptoms associated with hydroflouric acid exposure.

Question 3

Calcium - Metabolism

Answer 3

Most of the parenterally administered calcium filtered by the renal glomeruli is reabsorbed; the remainder is excreted in faeces

Question 4

Calcium - Indications

Answer 4

• Suspected hyperkalaemic cardiac arrest
• Severe hyperkalaemia (with haemodynamic compromise AND/OR significant cardiac rhythm disturbance
• Calcium channel blocker toxicity
• Hypotension associated with Magnesium infusion (with failure to respond to fluid therapy)
• Hydroflouric acid inhalation

Question 5

Calcium - Contraindications

Answer 5

• KSAR or hypersensitivity to Calcium Gluconate

- Digoxin (digitalis) overdose

Question 6

Calcium - Precautions

Answer 6

• Respiratory acidosis

Question 7

Calcium - Side Effects

Answer 7

Cardiac Arrest:
- Nil
All other indications:
- syncope
- hypotension
- bradycardia
- cardiac dysrhythmia
- cardiac arrest

Question 8

Calcium - Onset, Duration, Half-life

Answer 8

Onset - 1-3 min
Duration - 30-60 min
Half-life - N/a

Question 9

Calcium - Routes of Administration

Answer 9

• NEB
• IV
• IO

Question 10

Calcium - Adult Doses

Answer 10

IV - 10mL, slow push over 2-5 min, repeat once at 10 min

NEB - 2mL of 2.5% concentration (0.5mL of Ca with 1.5mL NS), repeat PRN

Question 11

Calcium - Paed Doses

Answer 11

IV - 05mL/kg (50mg/kg), slow push over 2-5 min, repeat once at 10 min