INTRODUCTION

Calcium gluconate is a mineral supplement. It is

manufactured by the neutralization of gluconic acid
with lime or calcium carbonate. Calcium gluconate has
been assigned to pregnancy category C by FDA. It is
considered as a nutritional supplement. The human
fetus is entirely depend on its mother for the supply of
nutrient encluding calcium and oxygen and removal of
waste product. Fetal accumulation of calcium occurs
mainly during the third trimester.
Generic Name
Calcium gluconate
Trade Name
Kalcinate
Cal-G
Cal-GLU
Available form
Contain 90mg or 4.5mEq of elemental calcium/g
# Injection – 10% solution in 10ml ampule and
vials,10ml or 50ml vials.
# Powder for oral suspension- 346.7 elemental
calcium/5ml.
# Tablet-500mg, 650mg, Ig.
Indication and Dosage
Hypocalcemia emergency
- Adult : 7mEq to 14 mEq calcium IV may given as a
10% calcium gluconate soln.
- Children : 1meq to 7mEq calcium IV.
- Infant : upto 1mEq
Hypocalcemia tetany
- Adult: 4.5mEq to 16 mEq calcium IV repeat until
tetany is controlled.
- Children : 0.5 to 0.7 mEq/kg calcium IV tid until
tetany is controlled.
- Neonate : 2.4 mEq/kg calcium IV daily is devided
doses.
Adjunctive treatment of magnesium intoxication.
- Adult : Initially 7mEq IV based subsequent doses on
patient respond.
During exchange transfusion
- 1.35mEq IV with each 100ml citrated blood.
Dietary supplement
- 500mg to 2g PO daily.
Mechanism of Action
Calcium plays a vital role in the physiology and
biochemistry of organism and the cells. It plays an
important role in signal transduction pathway, where
it act as a massenger in contraction of all the muscle
cell type and fertilization.
Calcium gluconate are absorbed well by pregnant
woman.
Adverse Reaction
CNS: - tingling sensation
- sense of oppression
- syncope
CV :- bradycardia
- arrythmias
- cardiac arrest
GI :- constipation
- irritation
- chalky taste.
 - haemorrhage
- nausea, vomiting, thirst,abdominal pain
GU :- polyurea
-renal calculi
Metabolic :- hypercalcemia
Skin :- local reaction
- necrosis
- tissue sloughing
- cellulitis
Contraindication
 Contraindicated in cancer patient with bone
metastasis and in those with ventricular fibrillation,
hypercalcemia, hypophosphatamia or renal calculi.
Nursing consideration
 Use all the calcium product with extreme caution in digitalised
patient and patient with sacroidosis and renal or cardiac diseases.
 Double checked that you are giving the correct form of calcium
resuscitation are ay contain both calcium gluconate and calcium
chloride.
 Monitor calcium level frequently . Maintain calcium level of 9 –
10.4 mg/dl.
 Sign and symptom of severe hypercalcemia may enclude
stupor ,confusion delirium, and coma.
 Dont confuse calcium with calcitriole , calcium gluconate with
calcium glubionate , calcium chloride with calcium gluconate.
Patient teaching
 Tell the patient to take oral calcium 1-11/2 hour after
meal if GI upset occur.
 Tell the patient to take oral calcium with a full glass of
water.
 Tell the patient to report anorexia nausea vomiting ,
constipation , abdominal pain , dry mouth , thirst or
polyurea.
 Warn the patient that in the meal before she takes
calcium.She should not have spinch hole grains cereals
or dry product these food may interfere with calcium
absorption.