Injections should be made slowly through a small needle into a large vein in order to avoid too rapid an increase in serum calcium and extravasation of calcium solution into the surrounding tissue with resulting necrosis. It is particularly important to prevent a high concentration of calcium from reaching the heart because of the danger of cardiac syncope. If injected into the ventricular cavity in cardiac resuscitation, it must not be injected into the myocardial tissue.
Rapid injection of calcium gluconate may cause vasodilation, decreased blood pressure, bradycardia, cardiac arrhythmias, syncope and cardiac arrest.
Rapid injection of calcium gluconate may cause vasodilation, decreased blood pressure, bradycardia, cardiac arrhythmias, syncope and cardiac arrest.
Adverse Reactions: Parenteral calcium may cause flushing, nausea, vomiting, drowsiness, sweating and hypotension. Vasomotor collapse may ensue if i.v. injection is too rapid.
Symptoms And Treatment Of Overdose: Symptoms: Untoward effects which may occur with parenterally administered calcium are related to the rate of injection.
Nausea, vomiting, diarrhea, sensations of heat and sweating; arrhythmias, hypotension, circulatory collapse.
Treatment: The patient should be in the horizontal position. Treat shock in the usual fashion.
Dosage And Administration: The dose is dependent on the requirements of the individual patient. I.V. calcium gluconate injection must be administered slowly, e.g. approximately 1.5 mL over a period of 1 minute.
To aid in converting: 1 g of elemental calcium=25 mmol elemental calcium=50 mEq elemental calcium=11.1 g calcium gluconate=111 mL of a 10% solution of calcium gluconate.
Adults: Initially, 5 to 20 mL of a 10% solution (500 mg to 2 g) injected slowly i.v. This dose may be repeated until tetany is controlled. A 0.3 to 0.8% solution [30 to 40 mL of a 10% solution in 500 to 1 000 mL of sodium chloride injection or dextrose 5% in water (D5W)] may then be infused by slow drip within a 3 to 12-hour period. The maximum dosage for adults is 15 g (150 mL of a 10% solution).
Children: The usual dose is 200 to 500 mg/kg/day well diluted and administered slowly i.v. in divided doses. Doses above 500 mg/kg/day are not recommended.
Availability And Storage: Each mL of sterile, nonpyrogenic, hypertonic solution contains: total calcium 0.465 mEq (9.3 mg), derived from calcium gluconate 94 mg and calcium D-saccharate tetrahydrate 4.5 mg (equivalent to calcium D-saccharate anhydrous 3.5 mg) in water for injection. Calcium D-saccharate provides 6% of the total calcium and stabilizes the supersaturated solution of calcium gluconate. Preservative-free. Single use vials of 10 mL.
Sodium hydroxide and/or hydrochloric acid is used to adjust pH to 6.0 to 8.2. The osmolality is 0.7 mOsmol/mL (calc.).
Supersaturated solutions are prone to precipitation. If precipitation is evident, vials may be heated to 80°C in a dry heat oven for a minimum of 1 hour. Shake vigorously. Allow to cool to room temperature before dispensing. The solution should not be used if the precipitate remains after following the above procedure.
Store at room temperature (15 to 30°C). Protect from freezing. Do not use if solution is unclear. Discard unused portion.
Symptoms And Treatment Of Overdose: Symptoms: Untoward effects which may occur with parenterally administered calcium are related to the rate of injection.
Nausea, vomiting, diarrhea, sensations of heat and sweating; arrhythmias, hypotension, circulatory collapse.
Treatment: The patient should be in the horizontal position. Treat shock in the usual fashion.
Dosage And Administration: The dose is dependent on the requirements of the individual patient. I.V. calcium gluconate injection must be administered slowly, e.g. approximately 1.5 mL over a period of 1 minute.
To aid in converting: 1 g of elemental calcium=25 mmol elemental calcium=50 mEq elemental calcium=11.1 g calcium gluconate=111 mL of a 10% solution of calcium gluconate.
Adults: Initially, 5 to 20 mL of a 10% solution (500 mg to 2 g) injected slowly i.v. This dose may be repeated until tetany is controlled. A 0.3 to 0.8% solution [30 to 40 mL of a 10% solution in 500 to 1 000 mL of sodium chloride injection or dextrose 5% in water (D5W)] may then be infused by slow drip within a 3 to 12-hour period. The maximum dosage for adults is 15 g (150 mL of a 10% solution).
Children: The usual dose is 200 to 500 mg/kg/day well diluted and administered slowly i.v. in divided doses. Doses above 500 mg/kg/day are not recommended.
Availability And Storage: Each mL of sterile, nonpyrogenic, hypertonic solution contains: total calcium 0.465 mEq (9.3 mg), derived from calcium gluconate 94 mg and calcium D-saccharate tetrahydrate 4.5 mg (equivalent to calcium D-saccharate anhydrous 3.5 mg) in water for injection. Calcium D-saccharate provides 6% of the total calcium and stabilizes the supersaturated solution of calcium gluconate. Preservative-free. Single use vials of 10 mL.
Sodium hydroxide and/or hydrochloric acid is used to adjust pH to 6.0 to 8.2. The osmolality is 0.7 mOsmol/mL (calc.).
Supersaturated solutions are prone to precipitation. If precipitation is evident, vials may be heated to 80°C in a dry heat oven for a minimum of 1 hour. Shake vigorously. Allow to cool to room temperature before dispensing. The solution should not be used if the precipitate remains after following the above procedure.
Store at room temperature (15 to 30°C). Protect from freezing. Do not use if solution is unclear. Discard unused portion.
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