Class: Electrolyte

Description

Calcium is an essential component for functional integrity of the nervous and muscular systems, normal cardiac contractility, and the coagulation of blood. Calcium chloride contains 27.2% elemental calcium. Calcium chloride should be administered intravenously (slowly, not exceeding 1 ml/min).

Onset & Duration

Onset: 5-15 min Duration: Dose dependent (effects may persist for 4 hr after IV administration)

Indications

Hypocalcemia (prompt increase in serum calcium levels)

Adjunctive therapy in the treatment of insect bites and stings (especially black widow spider and scorpion) Magnesium sulfate overdose Hyperkalemia

Cardiac resuscitation (questionable value) Calcium channel blocker toxicity Contraindications

VF during cardiac resuscitation In patients with digitalis toxicity Hypercalcemia

Adverse Reactions

Decrease in heart rate (may cause asystole) Decrease in blood pressure Peripheral vasodilation Metallic taste Severe local necrosis and sloughing after IM use or IV infiltration

Drug Interactions

Calcium may worsen dysrhythmias secondary to digitalis. May antagonize effects of verapamil. NOTE: It is important to flush IV line between administration of calcium chloride and sodium bicarbonate to avoid precipitation.

How Supplied 10% solution in 10 ml ampules, vials, and prefilled syringes (100 mg/ml) Dosage and AdministrationAdult: 2-4 mEq/kg of 10% solution IV. Repeat as necessary at 10-min intervals. Pediatric: 20 mg/kg/dose of 10% solution slow IV (maximum 1 g dose); may be repeated once in 10 min.

Special Considerations

Pregnancy safety: Category C. Calcium may produce vasospasm in coronary and cerebral arteries.