Category:

• Electrolyte and water

Description:

• Electrolyte

Indications:

• Treatment of hypocalcemia in conditions requiring a prompt increase in plasma calcium (10%)

• Treatment of magnesium intoxication (10%)

• Combat hyperkalemia as measured by electrocardiograph, pending correction of the increased potassium level in the extracellular fluid 91050

• Cardiac resuscitation when weak or inadequate contractions return following defibrillation or when epinephrine injection has failed to strengthen myocardial contractions (10%)

Contraindications:

• Cardiac resuscitation in presence of  ventricular fibrillation or in patients with existing digitalis toxicity

Precautions:

• Pregnancy category C

• Use with caution in digitalized patients

• Inject slowly into large vein to help prevent irritation and cardiac syncope

Adverse Reactions (Side Effects):

• With fast injection: tingling sensations, calcium taste, sense of oppression “heat wave”

• Peripheral vasodilatation

Dosage:

Administered ONLY by SLOW intravenous injection (1 ml/min) and/or intraventricular injection.  It must not be injected into the myocardium.

• Usual adult dose in hypocalcemic disorders 

  • 0.5-1g (5-10ml) at 1-3 day intervals, depending upon response.

• Magnesium intoxication: 

  • 500mg (5ml) IV promptly; observe patient for signs of recovery before further doses given

• Hyperkalemic ECG disturbances of cardiac function: 

  • Titrate according to ECG changes during administration

• Cardiac resuscitation: 

  • IV 0.5-1g (5-10ml); or, inject 200-800mg (2-8ml) into the ventricular cavity

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001