Calcium gluconate

Pharmacological properties

calcium gluconate (stabilized) - a means of regulating metabolic processes, replenishes the deficiency of calcium in the body, has a hemostatic, anti-allergic effect and reduces capillary permeability.

Calcium ions are involved in the transmission of nerve impulses, the contraction of smooth and striated muscles, the functioning of the myocardium, blood coagulation; they are necessary for the formation of bone tissue, the functioning of other systems and organs. The concentration of calcium ions in the blood decreases with many pathological processes; severe hypocalcemia contributes to tetany. In addition to eliminating hypocalcemia, calcium compounds reduce vascular permeability, have anti-allergic, anti-inflammatory, hemostatic effects.

Pharmacokinetics After parenteral administration, the drug is evenly distributed in all tissues and organs. In blood plasma, calcium is in an ionized state. Passes through the placental barrier, excreted in breast milk. It is excreted mainly by the kidneys.

Indications

Insufficiency of the function of the parathyroid glands; increased excretion of calcium from the body (in particular with prolonged dehydration); as an adjunct in allergic diseases (serum sickness, urticaria, angioedema) and allergic complications of drug therapy; to reduce vascular permeability in pathological processes of any genesis (exudative phase of the inflammatory process, hemorrhagic vasculitis, radiation sickness); parenchymal hepatitis, toxic liver damage, nephritis, eclampsia; hyperkalemia hyperkalemic form of paroxysmal myoplegia; skin diseases (itching, eczema, psoriasis); as a hemostatic agent; as an antidote for poisoning with magnesium salts, oxalic acid or its soluble salts, soluble salts of fluoric acid.

Application

Apply in / in or / m.

The ampoule with r-rum before administration is heated to body temperature. The solution is administered slowly over a period of 2-3 minutes.

Adults and children over the age of 14 years are injected with 5-10 ml of Calcium gluconate-Darnitsa (stabilized) daily or after 1-2 days, depending on the course of the disease and the patients condition.

For children only iv, depending on age, 10% calcium gluconate solution is administered in the following doses: under the age of 6 months - 0.1–1 ml, 6–12 months - 1–1.5 ml, 1– 3 years - 1.5–2 ml, 4–6 years - 2–2.5 ml, 7–14 years - 3-5 ml.

For the introduction of a solution in an amount of less than 1 ml, a single dose is adjusted to the appropriate volume (syringe volume) of 0.9% sodium chloride solution or 5% glucose solution.

Contraindications

Hypersensitivity to the components of the drug; tendency to thrombosis; hypercalcemia; severe hypercalciuria; severe atherosclerosis; increased blood coagulation; severe renal failure; sarcoidosis; simultaneous use with cardiac glycosides, ceftriaxone.

Side effects

With rapid administration, nausea, vomiting, increased sweating, a feeling of heaviness in the head, syncope, general weakness, arterial hypotension, vasomotor collapse, sometimes fatal are possible. sometimes diarrhea, bradycardia, a feeling of heat in the oral cavity, and then throughout the body, which quickly pass on their own, are possible; soft tissue calcification due to extravasation of calcium solution. IM injections of calcium salts can cause local irritation.

Very rarely, allergic and anaphylactic reactions are possible, up to anaphylactic shock.

special instructions

Calcium salts should be used with caution in patients with impaired renal function, with heart disease.

When used in patients who receive cardiac glycosides and / or diuretics, as well as with prolonged treatment (especially in children), it is necessary to control the concentration of calcium and creatinine in the blood. If their concentration increases, the dose of the drug should be reduced or its use temporarily discontinued.

With caution and with regular monitoring of urinary calcium excretion, it is prescribed to patients with moderate hypercalciuria exceeding 300 mg / day (7.5 mmol / day), not pronounced renal impairment, a history of urolithiasis. If necessary, reduce the dose or cancel it. Patients with a tendency to form calculi in the urinary tract during treatment are recommended to increase the amount of fluid consumed.

Before filling the syringe with calcium gluconate, it is necessary to make sure that there are no residues of ethyl alcohol, since gluconate precipitates as a result of interaction with calcium alcohol.

Use during pregnancy and lactation. The use of the drug during pregnancy and lactation is possible taking into account the ratio of benefits for the mother / risk for the fetus (child).

Children. For children under the age of 14 years, it is not recommended to administer the drug intramuscularly due to the possibility of necrosis.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. There is no data on the negative effect of the drug on the reaction rate when driving vehicles or working with other mechanisms.

Interactions

During the interaction of ethyl alcohol with calcium gluconate, the latter precipitates.

It is not recommended to be prescribed together with other calcium preparations.

In / in the introduction of calcium gluconate before and after taking verapamil reduces the severity of its hypotensive effect, but does not affect its antiarrhythmic effect.

The combination with thiazide diuretics can lead to the development of hypercalcemia.

With simultaneous use with quinidine, intraventricular conduction may slow down and quinidine toxicity may increase.

During treatment with cardiac glycosides, parenteral administration of calcium gluconate is not recommended due to increased cardiotoxicity.

Calcium gluconate eliminates the inhibition of neuromuscular transmission caused by the use of antibiotics of a number of aminoglycosides.

With simultaneous use with nifedipine, calcium preparations reduce its effectiveness.

Incompatibility. Pharmaceutically incompatible with ethyl alcohol, carbonates, salicylates, sulfates, tartrates.

Overdose

Symptoms: possible development of hypercalcemia. symptoms of hypercalcemia may include anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, polydipsia, polyuria, mental disorders, nephrocalcinosis, nephrolithiasis, in severe cases, arrhythmia and coma.

Treatment: with a slight overdose (calcium concentration in the blood plasma - 2.6–2.9 mmol / l), the administration is stopped and other calcium-containing drugs are canceled. In severe overdose (plasma calcium concentration of 2.9 mmol / l) parenteral calcitonin at a dose of 5-10 IU / kg body weight per day (diluting it with 500 ml of 0.9% sodium chloride solution), iv drip for 6 hours. Perhaps in / in a slow jet injection 2-4 times a day. Apply non-thiazide diuretics, monitor the concentration of potassium and magnesium in the blood plasma, if necessary, inject drugs of potassium and magnesium; they control the functions of the cardiovascular system, β-adrenoreceptor blockers are introduced to prevent arrhythmias. If necessary, hemodialysis is performed.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C. do not freeze.