Calcium Chloride and Gluconate

Chemical

CaCl2

2 Glutamate ions

1 Ca2+

Use

CaCl2

2 Glutamate ions

1 Ca2+

  1. Correct hypocalcaemia
  2. Inotropy
  3. Coagulation
  4. Hyperkalaemia
  5. Hypermagnesaemia
  6. Tx CCB overdose

Presentation

CaCl2

pH 5.5 – 7.5

Vial 10% of 10ml containing 1g elemental calcium in 10ml

2 Glutamate ions

1 Ca2+

pH 6.0 – 8.2

Vial of 10ml containing 0.22mmol/ml of elemental calcium

Dose

CaCl2

2 Glutamate ions

1 Ca2+

Maximum dose 3mmol/kg/day

Potency

CaCl2

6.8 mol Ca++ in 10mL

2 Glutamate ions

1 Ca2+

2.25 mol Ca++ in 10mL

Route

CaCl2

CVC only

2 Glutamate ions

1 Ca2+

IV

oral

Onset

CaCl2

2 Glutamate ions

1 Ca2+

Immediate

MoA

CaCl2

2 Glutamate ions

1 Ca2+

Dissociates to provide Ca++

PK

CaCl2

A

NA

D

NA

M

NA

E

80% fecal, 20% renal

2 Glutamate ions

1 Ca2+

A

1/5 of oral dose absorbed

D

PPB 45%

M

none

E

80% fecal, 20% renal

Adverse Effects

CaCl2

Highly irritant to veins

Rash, pain, burning, extravasation

Nephrolithiasis (longT)

Gastric irritation

Diarrhoea

CNS: feeling abnormal (sense of oppression), tingling

CVS – bradycardia, cardiac arrest, arrythmias, hypotension, syncope, vasodilation

2 Glutamate ions

1 Ca2+

Irritant to veins

Rash, pain, burning, extravasation

Nephrolithiasis (longT)

Gastric irritation

Diarrhoea

CNS: feeling abnormal (sense of oppression), tingling

CVS – bradycardia, cardiac arrest, arrythmias, hypotension, syncope, vasodilation

Drug Interactions

CaCl2

2 Glutamate ions

1 Ca2+

Ceftriaxone – insoluble precpitates can be fatal

Digoxin – risk of arrythmia, CV collapse

Thiazide – increased risk hypercalcaemia

Ketoconazole – reduces effects of ketoconazole