Calcium Chloride: Class, Use, Dose, Pharmakinetics
Use: to treat hyperkalemia (elevated potassium), hypocalcemia, hypermagnesemia and calcium channel blocker toxicity
- Dose: Adult 2 to 4 mg/kg (10% solution) IV every 10 min as needed
- Peds 20 mg/kg (10% solution) IV repeated once in 10 min as needed
- Onset and peak effects are immediate
- duration is unknown
- Crosses placenta
Actions, contraindications and interactions of Calcium Chloride
- Action: provides elemental calcium in form of cation Ca++
- Its execss chloride ions promote acidosis and temporary diuresis secondary to excretion of sodium.
- Used as an antidote for some electrolyte imbalances, mag sulfate overdose and minimize side effects from calcium channel blocker usage
- it ionizes more readily then calcium gluconate and is therefore more potent and irritation to tissues. Actions are similar to calcium gluconate
- Contraindications: in V-Fib, hypercalcemia, and possible digitalis toxicity.
- Used with caution in pts taking digoxin, pregnancy prior to labor, nursing mothers, and children.
Interactions: will interact sodium bicarb and form a precipitate. May enhance inotropic and toxic effects of digoxin and antagonize the effects of verapamil and other calcium channel blocker
Side effects of Calcium Chloride
- Side effects: CNS: tingling sensation, fainting
- Skin: sensation of heat waves (peripheral vasodilation), pain, burning at IV site, necrosis and sloughing
- CV: hypotension, bradycardia, cardiac dysrhythmias, cardiac arrest, severe venous thrombosis
Give 0.5 to 1.0 mL/min or slower to avoid cllulitis, necrosis and sloughing at IV site
Use small bore needle in larg vein to minimize venous irritation and undesirable reactions
BP may fall after IV injection so monitor BP, EKG, flow rate and watch pt closely
Flush IV line prior to and immediately following administration of such drugs as sodium bicarb, or other catecholamines to avoid precipitate.