Clinical data | |
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Pronunciation | KAL-see-um GLUE-koe-nate |
AHFS/Drugs.com | Monograph |
License data | |
Routes of administration | By mouth, intravenous, topical |
ATC code | |
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CAS Number | |
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ChEBI | |
ChEMBL | |
E number | E578 (acidity regulators, ...) |
CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.005.524 |
Chemical and physical data | |
Formula | C12H22CaO14 |
Molar mass | 430.372 g·mol−1 |
3D model (JSmol) | |
Melting point | 120 °C (248 °F) (decomposes) |
Solubility in water | slowly soluble |
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Calcium gluconate is the calcium salt of gluconic acid and is used as a mineral supplement and medication. [1] As a medication it is used by injection into a vein to treat low blood calcium, high blood potassium, and magnesium toxicity. [1] [2] Supplementation is generally only required when there is not enough calcium in the diet. [3] Supplementation may be done to treat or prevent osteoporosis or rickets. [1] It can also be taken by mouth but is not recommended for injection into a muscle. [1]
Side effects when injected include slow heart rate, pain at the site of injection, and low blood pressure. [3] When taken by mouth side effects may include constipation and nausea. [1] Blood calcium levels should be measured when used and extra care should be taken in those with a history of kidney stones. [3] At normal doses, use is regarded as safe in pregnancy and breastfeeding. [1] [4] Calcium gluconate is made by mixing gluconic acid with calcium carbonate or calcium hydroxide. [5]
Calcium gluconate came into medical use in the 1920s. [6] It is on the World Health Organization's List of Essential Medicines. [7] Calcium gluconate is available as a generic medication. [2] [8]
Calcium gluconate is produced commercially through three main methods. These three methods are: chemical oxidation of glucose with a hypochlorite solution, electrolytic oxidation of a glucose solution containing a known value of bromide, and a fermentation process where specific microorganisms are grown in a medium containing glucose and various other ingredients. [9]
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10% calcium gluconate solution (given intravenously) is the form of calcium most widely used in the treatment of low blood calcium. This form of calcium is not as well absorbed as calcium lactate, [10] and it only contains 0.93% (930 mg/dL) calcium ion (defined by 1 g weight solute in 100 mL of solution to make 1% solution w/v). Therefore, if the hypocalcemia is acute and severe, calcium chloride is given instead.
Calcium gluconate is used as a cardioprotective agent in people with high blood potassium levels, with one alternative being the use of calcium chloride. [11] It is recommended when the potassium levels are high (>6.5 mmol/L) or when the electrocardiogram (ECG) shows changes due to high blood potassium. [2]
Though it does not have an effect on potassium levels in the blood, it reduces the excitability of cardiomyocytes, thereby lowering the likelihood of cardiac arrhythmias. [12]
It is also used to counteract an overdose of Epsom salts magnesium sulfate, [13] which is often administered to pregnant women in order to prophylactically prevent seizures (as in a patient experiencing preeclampsia). Magnesium sulfate is no longer given to pregnant women who are experiencing premature labor in order to slow or stop their contractions (other tocolytics are now used instead due to better efficacy and side effect profiles).[ citation needed ] Excess magnesium sulfate results in magnesium sulfate toxicity, which results in both respiratory depression and a loss of deep tendon reflexes (hyporeflexia).
Gel preparations of calcium gluconate are used to treat hydrofluoric acid burns. [14] [15] The calcium gluconate reacts with hydrofluoric acid to form insoluble, non-toxic calcium fluoride. In addition to a 2.5% calcium gluconate gel being applied directly to the chemical burn, the person may also receive calcium gluconate supplements because the fluoride ion precipitates serum calcium, causing hypocalcemia. [16]
While intravenous calcium has been used in cardiac arrest, its general use is not recommended. [1] Cases of cardiac arrest in which it is still recommended include high blood potassium, low blood calcium such as may occur following blood transfusions, and calcium channel blocker overdose. [1] There is the potential that general use could worsen outcomes. [1] If calcium is used, calcium chloride is generally the recommended form. [1]
Calcium gluconate side effects include nausea, constipation, and upset stomach. Rapid intravenous injections of calcium gluconate may cause hypercalcemia, which can result in vasodilation, cardiac arrhythmias, decreased blood pressure, and bradycardia. Extravasation of calcium gluconate can lead to cellulitis. Intramuscular injections may lead to local necrosis and abscess formation. [17]
It is also reported that this form of calcium increases renal plasma flow, urine production, sodium excretion, [18] [19] glomerular filtration rate, [20] and prostaglandin E2 and F1-alpha levels. [21]
Suxamethonium chloride, also known as suxamethonium or succinylcholine, or simply sux in medical abbreviation, is a medication used to cause short-term paralysis as part of general anesthesia. This is done to help with tracheal intubation or electroconvulsive therapy. It is administered by injection, either into a vein or into a muscle. When used in a vein, onset of action is generally within one minute and effects last for up to 10 minutes.
ATC code A12Mineral supplements is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products. Subgroup A12 is part of the anatomical group A Alimentary tract and metabolism.
ATC code B05Blood substitutes and perfusion solutions is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products. Subgroup B05 is part of the anatomical group B Blood and blood forming organs.
Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the body. They help to regulate heart and neurological function, fluid balance, oxygen delivery, acid–base balance and much more. Electrolyte imbalances can develop by consuming too little or too much electrolyte as well as excreting too little or too much electrolyte. Examples of electrolytes include calcium, chloride, magnesium, phosphate, potassium, and sodium.
Hypokalemia is a low level of potassium (K+) in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abnormal heart rhythm, which is often too slow and can cause cardiac arrest.
Hypermagnesemia is an electrolyte disorder in which there is a high level of magnesium in the blood. Symptoms include weakness, confusion, decreased breathing rate, and decreased reflexes. Complications may include low blood pressure and cardiac arrest.
Gluconic acid is an organic compound with molecular formula C6H12O7 and condensed structural formula HOCH2(CHOH)4CO2H. A white solid, it forms the gluconate anion in neutral aqueous solution. The salts of gluconic acid are known as "gluconates". Gluconic acid, gluconate salts, and gluconate esters occur widely in nature because such species arise from the oxidation of glucose. Some drugs are injected in the form of gluconates.
Ringer's lactate solution (RL), also known as sodium lactate solution,Lactated Ringer's, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure. It may also be used to treat metabolic acidosis and to wash the eye following a chemical burn. It is given by intravenous infusion or applied to the affected area.
Calcium lactate is a white crystalline salt with formula C
6H
10CaO
6, consisting of two lactate anions H
3C(CHOH)CO−
2 for each calcium cation Ca2+
. It forms several hydrates, the most common being the pentahydrate C
6H
10CaO
6·5H
2O.
Magnesium deficiency is an electrolyte disturbance in which there is a low level of magnesium in the body. It can result in multiple symptoms. Symptoms include tremor, poor coordination, muscle spasms, loss of appetite, personality changes, and nystagmus. Complications may include seizures or cardiac arrest such as from torsade de pointes. Those with low magnesium often have low potassium.
Iron supplements, also known as iron salts and iron pills, are a number of iron formulations used to treat and prevent iron deficiency including iron deficiency anemia. For prevention they are only recommended in those with poor absorption, heavy menstrual periods, pregnancy, hemodialysis, or a diet low in iron. Prevention may also be used in low birth weight babies. They are taken by mouth, injection into a vein, or injection into a muscle. While benefits may be seen in days, up to two months may be required until iron levels return to normal.
Calcium lactate gluconate, also known as GLOCAL, is a soluble salt of calcium, lactic acid and gluconic acid used in effervescent calcium tablets. Its chemical formula is Ca5(C3H5O3)6·(C6H11O7)4·2H2O. It was first developed by Sandoz, Switzerland. Calcium lactate gluconate is used in the functional and fortified food industry due to its good solubility and neutral taste. In addition, it is used in various spherification techniques in molecular gastronomy. It can also be used to help neutralize HF (hydrofluoric acid) poisoning.
Magnesium gluconate is a compound with formula MgC12H22O14. It is the magnesium salt of gluconic acid.
A volume expander is a type of intravenous therapy that has the function of providing volume for the circulatory system. It may be used for fluid replacement or during surgery to prevent nausea and vomiting after surgery.
Ringer's solution is a solution of several salts dissolved in water for the purpose of creating an isotonic solution relative to the body fluids of an animal. Ringer's solution typically contains sodium chloride, potassium chloride, calcium chloride and sodium bicarbonate, with the last used to balance the pH. Other additions can include chemical fuel sources for cells, including ATP and dextrose, as well as antibiotics and antifungals.
Magnesium salts are available as a medication in a number of formulations. They are used to treat magnesium deficiency, low blood magnesium, eclampsia, and several other conditions. Magnesium is an essential nutrient.
Patiromer, sold under the brand name Veltassa, is a medication used to treat high blood potassium. It is taken by mouth. It works by binding potassium in the gut.
Calcium supplements are salts of calcium used in a number of conditions. Supplementation is generally only required when there is not enough calcium in the diet. By mouth they are used to treat and prevent low blood calcium, osteoporosis, and rickets. By injection into a vein they are used for low blood calcium that is resulting in muscle spasms and for high blood potassium or magnesium toxicity.
Magnesium sulfate as a medication is used to treat and prevent low blood magnesium and seizures in women with eclampsia. It is also used in the treatment of torsades de pointes, severe asthma exacerbations, constipation, and barium poisoning. It is given by injection into a vein or muscle as well as by mouth. As epsom salts, it is also used for mineral baths.
A hydrofluoric acid burn is a chemical burn from hydrofluoric acid. Where it contacts the skin it results in significant pain, swelling, redness, and skin breakdown. If the fumes are breathed in swelling of the upper airway and bleeding may occur. Complications can include electrolyte, heart, lung, kidney, and neurological problems.