Introduction
Calcium gluconate is used as mineral supplement and medication when there is insufficient calcium in the diet. Supplementation may be done to treat or prevent osteoporosis or rickets, consequences of hypocalcemia. It can also be taken by mouth but is not recommended by injection into a muscle. Calcium Gluconate Injection, USP is a sterile, nonpyrogenic supersaturated solution of calcium gluconate for intravenous use only. Each mL contains: Calcium gluconate 94 mg; calcium saccharate (tetrahydrate) 4.5 mg; water for injection q.s. Hydrochloric acid and/or sodium hydroxide may have been added for pH adjustment (6.0 to 8.2). Calcium saccharate provides 6% of the total calcium and stabilizes the supersaturated solution of calcium gluconate. Each 10 mL of the injection provides 93 mg elemental calcium (Ca++) equivalent to 1 g of calcium gluconate.
Uses
Calcium gluconate is an ingredient found in a variety of supplements and vitamins, and is used to lower potassium in the blood or treat magnesium poisoning.
Oral calcium salts are used as dietary supplemental therapy for person who may not get enough calcium in their regular diet. Calcium gluconate is used as a cardioprotective agent in high blood potassium. Calcium gluconate is the antidote for magnesium sulfate toxicity.
Associated Conditions
Pharmacodynamics
Calcium Gluconate is the gluconate salt of calcium. An element or mineral necessary for normal nerve, muscle, and cardiac function, calcium as the gluconate salt helps to maintain calcium balance and prevent bone loss when taken orally. This agent may also be chemopreventive for colon and other cancers.
Mechanism of Action
Calcium is essential for the functional integrity of the nervous, muscular, and skeletal systems. It plays a role in normal cardiac function, renal function, respiration, blood coagulation, and cell membrane and capillary permeability. Also, calcium helps to regulate the release and storage of neurotransmitters and hormones, the uptake and binding of amino acids, absorption of vitamin B 12, and gastrin secretion. The major fraction (99%) of calcium is in the skeletal structure primarily as hydroxyapatite, Ca 10(PO 4) 6(OH) 2; small amounts of calcium carbonate and amorphous calcium phosphates are also present. The calcium of bone is in a constant exchange with the calcium of plasma. Since the metabolic functions of calcium are essential for life, when there is a disturbance in the calcium balance because of dietary deficiency or other causes, the stores of calcium in bone may be depleted to fill the body's more acute needs. Therefore, on a chronic basis, normal mineralization of bone depends on adequate amounts of total body calcium.
Absorption
Approximately one-fifth to one-third of orally administered calcium is absorbed in the small intestine, depending on presence of vitamin D metabolites, pH in lumen, and on dietary factors, such as calcium binding to fiber or phytates. Calcium absorption is increased when a calcium deficiency is present or when a patient is on a low-calcium diet. In patients with achlorhydria or hypochlorhydria, calcium absorption, especially with the carbonate salt, may be reduced.
Volume of Distribution
Not available
Protein Binding
Moderate, approximately 45% in plasma.
Route of Elimination
Renal (20%) - The amount excreted in the urine varies with degree of calcium absorption and whether there is excessive bone loss or failure of renal conservation. Fecal (80%) - Consists mainly of nonabsorbed calcium, with only a small amount of endogenous fecal calcium excreted.
Toxicity
Infants : LDLo (Intramuscular ) : 10gm/kg ; Effects - Brain and coverings : meningeal changes Infants : TDLo ( Intramuscular ) : 143 mg/kg ; Effects - Dermatits Mouse: LD50 ( intravenous ) : 950mg/kg Mouse : LDLo (Oral ) : 10gm/kg
Food Interactions
- Take with a full glass of water.
- Take with food.
Dosage
- Acute hypocalcemia: 10-20 ml (2.32-4.64 m.mol)/Kg.
- Body weight Fluoride or lead poisoning: 0.3 ml/Kg Body weights.
- Neonatal tetany: 0.3 (0.7 m.mo)/Kg body weight.
