Calcium Chloride 10%

5.7 Calcium Chloride 10%
 
 

CLASS
Mineral, Calcium supplement, Electrolyte

ACTIONS
Calcium chloride increases the force of myocardial contraction; calcium may either increase or decrease systemic vascular resistance. In normal hearts, calcium's positive inotropic and vaso-constricting effects produce a predictable rise in systemic areterial pressure.

INDICATIONS
Calcium chloride is indicated during resuscitation for the treatment of hypocalcemia and calcium channel blocker toxicity (e.g. Verapamil or Cardizem overdose) and magnesium sulfate overdose. It also protects the heart from hyperkalemia as may occur in patients with end-stage renal disease.

CONTRAINDICATIONS
Cardiopulmonary arrest not associated with calcium channel blocker toxicity, hypocalcemia, or hyperkalemia.

ADVERSE REACTIONS AND SIDE EFFECTS
If the heart is beating, rapid administration of calcium can produce slowing of cardiac rate.

WARNINGS
Calcium chloride should not be administered in the same infusion with sodium bicarbonate, since calcium will combine with sodium bicarbonate to form an insoluble precipitate (calcium carbonate). Calcium chloride should be given with extreme caution, and in reduced dosage, to persons taking digitalis because it increases ventricular irritability and may precipitate digitalis toxicity.

DOSAGE
Adult: For hypotension following administration of calcium channel blockers (e.g. Cardizem, Verapamil): 4 mg/kg IV, slowly. If patient is taking digitalis, 2 mg/kg IV, slowly. Repeat every 10 min. PRN.
For calcium channel blocker overdose and hyperkalemia: 8-16 mg/kg IV, slowly.

Pediatric: 20 mg/kg slowly, over 10 min. PRN.
For calcium channel blocker overdose and hyperkalemia: 1gm IV, slowly.