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Lesson 5 of11
In Progress

Calcium Salts

Jimmy October 26, 2021

In emergency situations wherein there is cardiac toxicity, muscle weakness, or when K+ serum levels is > 6.5 mEq/L, initial therapy should be IV calcium to immediately stabilize the myocardium and protect it against possible arrhythmias due to inconsistent cell polarization. However, IV calcium is not useful to reduce serum K+ levels, so therapies to shift potassium into cells must be carried out such as administration of Insulin and beta-agonists.


A. Calcium Chloride

  • Mechanism of Action: Antagonizes cardiac conduction abnormalities
  • Dose: Intravenous, 5-10 mL
  • Pharmacokinetics:
    • Onset of Action: 1-3 mins
    • Duration of Effect: 30-50 mins
  • Contraindications: High risk of arrhythmia for patients taking digoxin
  • Adverse Effects: Hypercalcemia
  • Pearls: Has high levels of calcium therefore needs a central line administration; ECG must be done continuously because of the shortlived benefit

B. Calcium Gluconate

  • Mechanism of Action: Antagonizes cardiac conduction abnormalities
  • Dose: Intravenous, 10-20 mL
  • Pharmacokinetics:
    • Onset of Action: 1-3 mins
    • Duration of Effect: 30-50 mins
  • Contraindications: High risk of arrhythmia for patients taking digoxin
  • Adverse Effects: Hypercalcemia
  • Pearls: Initial dose of 1g IV preferred because of lower risk of tissue necrosis in case of tissue extravasation; safe administration in peripheral vein