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Functional Class
Electrolyte
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Mechanism of Action
- Replaces elemental calcium (essential for regulating excitation of nerves and muscle, also: clotting, renal function and bone tissue)
- Increases myocardial force and ventricular automaticity
- Additionally serves as an antidote for mag sulfate and calcium channel blocker toxicity.
- Calcium chloride has three times more elemental calcium than calcium gluconate
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Indications
- Calcium channel blocker toxicity/overdose
- Prophalactically prior to IV calcium channel blockers
- Acute hyperkalemia, hypermagnesia or hypocalcemia
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Contraindications
- VF
- Hypercalcemia
- Digitalis toxicity
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Precautions
- Flush IV line between calcium chloride and sodium bicarbonate. (Will form precipitate)
- Monitor for tissue necrosis at injection site
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Side Effects
- Dysrhythmias including bradycardia
- Cardiac arrest
- Cyncope
- N/V
- Hypotension
- Necrosis with extravasation
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Interaction
- Sodium bicarbonate
- Toxicity with digitalis
- Antagonizes calcium channel blockers
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Dosage and Route
- Hyperkalemia and calcium channel blocker overdose:
- 8-16 mg/kg of 10% solution slow IVP q 10 mins prn
- Prophylactic treatment prior to calcium channel blockers:
- 2-4 mg/kg of 10% solution slow IVP
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