Calcium Chloride 10%

 


Other Names

Calcijet


Clasification

Calcium Replacement


Action

  1. •Ca++ is an essential component for proper functioning nervous, muscular, skeletal and endocrine systems

  2. •Positive inotrope & dromotrope


Indications

  1. •Hypermagnesemia

  2. •Low serum calcium level

  3. •Overdose of calcium channel blockers

  4. •Hyperkalemic cardiac arrest

  5. •Tx of insect bites and stings, particularly black widow spiders and scorpions


Contraindications

  1. •Hypersensitivity to the medication

  2. •Digoxin toxicity


Precautions

  1. •Irritation with extravasation (may cause tissue necrosis)

  2. •Rapid IV administration may cause tingling sensations, a calcium taste, a sense of oppression or “heat waves”

  3. •Cardiotoxicity and local phlebitis with rapid IV administration

  4. •Use cautiously in patients with renal insufficiency or history of cardiac disease


Adverse Reactions

  1. •Hypersensitivity reactions (hypotension, bradycardia)

  2. •Flushing, nausea, vomiting, drowsiness, ventricular irritability

  3. •Hypotension, bradycardia, arrhythmias, asystole, VF


Interactions/Compatibility/Stability

  1. •Stable at room temperature

  2. •Incompatible with potassium, sodium bicarbonate, tetracycline

  3. •Compatible with NS and Dextrose solutions, R/L


Special Considerations

  1. •Calcium chloride is 3 X more potent than calcium gluconate

  2. •Antidote for overdose - magnesium sulfate IV

  3. •Avoid rapid administration to all patients (slow IV push, over 5 - 10 minutes) especially digitalized ones

  4. •Elemental calcium content is 31% (compared to 9% for the gluconate salt)

  5. •Anticoagulants in banked blood bind to unbound Ca++

  6. •Use infusion devices for all infusions


Dosages

Preparation: 1 gm/10 ml preload (100 mg/ml) 10%

Adult: 8 - 16 mg/kg (usually 5 - 10 ml) IV for hyperkalemia and calcium channel blocker overdose, prn 2 - 4 mg/kg (usually 2 ml) IV for prophylaxis before IV calcium channel blockers

Pediatric: 20 mg/kg (0.2 ml/kg) slow IV/IO push, repeat for documented conditions

Administer calcium chloride < 1 ml/min and Calcium gluconate < 2-3 ml/min


Kinetics

Onset           Immediate

Peak             No documentation found

Duration      30 minutes – 2 hours



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