Calcium gluconate 10% solution = 0.22mmol/ml Ca
Treatment of calcium deficiency
As an adjunct in hyperkalaemia
As an inotrope (in PICU)
Vasodilation leading to hypotension
Nausea, vomiting, hot flushes and sweating
IV and IM can cause local tissue reactions including irritation and necrosis
Excreted mainly in urine but also found in faeces and saliva, sweat, breast milk, bile and pancreatic juice
IM & S/C not recommended
Not to be given via ETT
Dose: 0.5ml/kg of 10% solution (maximum 20 mls) Given via large peripheral vein or CVC only
Can be given neat as a SLOW IV push over 3-5 minutes
For IV infusion – Calcium Gluconate can be neat or diluted to half strength and given over 1 hour. If continuous infusion, syringe should be used in 24 hours.
Can be added to TPN
In cardiac arrest can be given over 10-20 secs
Serum calcium levels should be carefully monitored ECG should be monitored
Extravasation should be avoided – give through a CVC when possible
Care in patients with renal failure
Glucose 5%, Normal Saline, Hartmann’s
Amikacin, aminophylline, amioderone, aztreonam, benzylpenicillin, cefepime, dexmedetomidine, frusemide, heparin, hydrocortisone, labetalol, lignocaine, linezolid, magnesium sulphate, metaraminol, midazolam, milrinone, noradrenaline, phenobarbitone, piperacillin-tazobactam, potassium chloride, propofol, remifentanil, tobramycin, vancomycin, verapamil.
Adrenaline, amphotericin B2, ampicillin, cefalotin, ceftriaxone, cephalothin, cephamandole, clindamycin, dexamethasone,sodium phosphate, diazepam, digoxin, dobutamine, flucloxacillin, fluconazole, meropenem, methylprednisolone, metoclopramide, pantoprazole, phenytoin, phosphate salts, prochlorperazine, sodium bicarbonate
PMH ED Guidelines – Calcium Gluconate 10% – last updated September 2014
PICU Drug File Reviewed October 2012 The Extra Pharmacopoeia 35 th Edition (2007) Martindale, EMIMS 2012 Australian Injectable Drugs Handbook 5 rthEdition (2011) The Society of Hospital Pharmacists of Australia Shann, F. Drug Doses (2010) 15 th Edition Paediatric Dosage Handbook International 17 th Edition (2011) Taketomo, CK, Hodding, JH & Kraus, DM. Drug Manufacturer Product Information E/Clinical Pharmacology 2012
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Author / Reviewer
Kids Health WA Guidelines Team
Dr Meredith Borland HoD, PMH Emergency Department
11 September, 2014
11 September, 2014