Calcium gluconate

Last updated

Calcium gluconate
Calcium gluconate.svg
Calcium-gluconate-chain-from-xtal-3D-bs-17.png
Clinical data
Pronunciation KAL-see-um GLUE-koe-nate
AHFS/Drugs.com Monograph
License data
Routes of
administration 		By mouth, intravenous, topical
ATC code
Identifiers
  • calcium (2R,3S,4R,5R)- 2,3,4,5,6-pentahydroxyhexanoate
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
E number E578 (acidity regulators, ...) OOjs UI icon edit-ltr-progressive.svg
CompTox Dashboard (EPA)
ECHA InfoCard 100.005.524 OOjs UI icon edit-ltr-progressive.svg
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
  • [Ca+2].[O-]C(=O)[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO.[O-]C(=O)[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO
  • InChI=1S/2C6H12O7.Ca/c2*7-1-2(8)3(9)4(10)5(11)6(12)13;/h2*2-5,7-11H,1H2,(H,12,13);/q;;+2/p-2/t2*2-,3-,4+,5-;/m11./s1
  • Key:NEEHYRZPVYRGPP-IYEMJOQQSA-L

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]

Contents

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]

It is closely related to calcium borogluconate, which is commonly used in veterinary medicine owning to its higher solubility. [9] It is used for intravenous administration of calcium, notably in ruminants. [10]

Production

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. [11]

Medical uses

Low blood calcium

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, [12] and it only contains 0.93% (93 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.

High blood potassium

Calcium gluconate is used as a cardioprotective agent in people with high blood potassium levels, with one alternative being the use of calcium chloride. [13] 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. [14]

Magnesium sulfate overdose

It is also used to counteract an overdose of Epsom salts magnesium sulfate, [15] 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).

Hydrofluoric acid burns

A tube of calcium gluconate gel Calcium gluconate gel.jpg
A tube of calcium gluconate gel

Gel preparations of calcium gluconate are used to treat hydrofluoric acid burns. [16] [17] 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. [18]

Cardiac arrest

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]

Side effects

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. [19]

It is also reported that this form of calcium increases renal plasma flow, urine production, sodium excretion, [20] [21] glomerular filtration rate, [22] and prostaglandin E2 and F1-alpha levels. [23]

Society and culture

See also

Related Research Articles

<span class="mw-page-title-main">Potassium chloride</span> Ionic compound (KCl)

Potassium chloride is a metal halide salt composed of potassium and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a salt-like taste. Potassium chloride can be obtained from ancient dried lake deposits. KCl is used as a fertilizer, in medicine, in scientific applications, domestic water softeners, and in food processing, where it may be known as E number additive E508.

<span class="mw-page-title-main">Suxamethonium chloride</span> Chemical compound

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.

<span class="mw-page-title-main">Magnesium sulfate</span> Chemical compound with formula MgSO4

Magnesium sulfate or magnesium sulphate is a chemical compound, a salt with the formula MgSO4, consisting of magnesium cations Mg2+ (20.19% by mass) and sulfate anions SO2−4. It is a white crystalline solid, soluble in water but not in ethanol.

<span class="mw-page-title-main">Hypocalcemia</span> Low calcium levels in ones blood serum

Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum. The normal range of blood calcium is typically between 2.1–2.6 mmol/L, while levels less than 2.1 mmol/L are defined as hypocalcemic. Mildly low levels that develop slowly often have no symptoms. Otherwise symptoms may include numbness, muscle spasms, seizures, confusion, or in extreme cases cardiac arrest.

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.

<span class="mw-page-title-main">Electrolyte imbalance</span> Abnormality in the concentration of electrolytes in the body

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.

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. Hypermagnesemia can greatly increase the chances of adverse cardiovascular events. Complications may include low blood pressure and cardiac arrest.

<span class="mw-page-title-main">Gluconic acid</span> Chemical compound

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.

<span class="mw-page-title-main">Ringer's lactate solution</span> Fluid used for resuscitation after blood loss

Ringer's lactate solution (RL), also known as sodium lactate solution,Lactated Ringer's (LR), 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.

<span class="mw-page-title-main">Calcium lactate</span> Chemical compound

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. 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.

<span class="mw-page-title-main">Calcium lactate gluconate</span> Chemical compound

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.

<span class="mw-page-title-main">Magnesium gluconate</span> Chemical compound

Magnesium gluconate is a compound with formula MgC12H22O14. It is the magnesium salt of gluconic acid.

<span class="mw-page-title-main">Intravenous sodium bicarbonate</span> Pharmaceutical drug

Intravenous sodium bicarbonate, also known as sodium hydrogen carbonate, is a medication primarily used to treat severe metabolic acidosis. For this purpose it is generally only used when the pH is less than 7.1 and when the underlying cause is either diarrhea, vomiting, or the kidneys. Other uses include high blood potassium, tricyclic antidepressant overdose, and cocaine toxicity as well as a number of other poisonings. It is given by injection into a vein.

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.

<span class="mw-page-title-main">Calcium supplement</span> Dietary mineral supplement

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.

<span class="mw-page-title-main">Medical uses of magnesium sulfate</span> Pharmaceutical compound

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.

<span class="mw-page-title-main">Hydrofluoric acid burn</span> Medical condition

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.

References

  1. 1 2 3 4 5 6 7 8 9 10 "Calcium Salts". The American Society of Health-System Pharmacists. Archived from the original on 18 January 2017. Retrieved 8 January 2017.
  2. 1 2 3 British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. pp. 680, 694. ISBN   9780857111562.
  3. 1 2 3 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 497. hdl:10665/44053. ISBN   9789241547659.
  4. ↑ "Calcium gluconate Use During Pregnancy | Drugs.com". www.drugs.com. Archived from the original on 18 January 2017. Retrieved 15 January 2017.
  5. ↑ Bhattacharya S (2014). Conventional and Advanced Food Processing Technologies. John Wiley & Sons. p. 391. ISBN   9781118406304. Archived from the original on 18 September 2017.
  6. ↑ Tegethoff FW (2012). Calcium Carbonate: From the Cretaceous Period into the 21st Century. Birkhäuser. p. 308. ISBN   9783034882453. Archived from the original on 18 September 2017.
  7. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  8. ↑ "Competitive Generic Therapy Approvals". U.S. Food and Drug Administration (FDA). 29 June 2023. Archived from the original on 29 June 2023. Retrieved 29 June 2023.
  9. ↑ Macpherson HT, Stewart J (January 1938). "Investigations on the nature of calcium borogluconate". Biochemical Journal. 32 (1): 76–78. doi:10.1042/bj0320076. PMC   1263995 . PMID   16746604.
  10. ↑ Constable, P (November 2003). "Fluid and electrolyte therapy in ruminants". Veterinary Clinics of North America: Food Animal Practice. 19 (3): 557–597. doi:10.1016/S0749-0720(03)00054-9. PMID   14608802.
  11. ↑ Shindia AA, El-Sherbeny GA, El-Esawy AE, Sheriff YM (March 2006). "Production of gluconic Acid by some local fungi". Mycobiology. 34 (1): 22–29. doi:10.4489/MYCO.2006.34.1.022. PMC   3769535 . PMID   24039465.
  12. ↑ Spencer H, Scheck J, Lewin I, Samachson J (July 1966). "Comparative absorption of calcium from calcium gluconate and calcium lactate in man". The Journal of Nutrition. 89 (3): 283–292. doi:10.1093/jn/89.3.283. PMID   4288031.
  13. 1 2 Miller D, Faine B (December 2013). "The Calcium Quandary". Emergency Physicians Monthly. Archived from the original on 21 November 2015. Retrieved 20 November 2015.
  14. ↑ Parham WA, Mehdirad AA, Biermann KM, Fredman CS (2006). "Hyperkalemia revisited". Texas Heart Institute Journal. 33 (1): 40–47. PMC   1413606 . PMID   16572868.
  15. ↑ Omu AE, Al-Harmi J, Vedi HL, Mlechkova L, Sayed AF, Al-Ragum NS (2008). "Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait". Medical Principles and Practice. 17 (3): 227–232. doi:10.1159/000117797. PMID   18408392. S2CID   3079436.
  16. ↑ el Saadi MS, Hall AH, Hall PK, Riggs BS, Augenstein WL, Rumack BH (June 1989). "Hydrofluoric acid dermal exposure". Veterinary and Human Toxicology. 31 (3): 243–247. PMID   2741315.
  17. ↑ Roblin I, Urban M, Flicoteau D, Martin C, Pradeau D (2006). "Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate". Journal of Burn Care & Research. 27 (6): 889–894. doi:10.1097/01.BCR.0000245767.54278.09. PMID   17091088. S2CID   3691306.
  18. ↑ Urden LD (2014). Critical Care Nursing : Diagnosis and Management (7th ed.). St. Louis, Mo.: Elsevier/Mosby. p. 936. ISBN   978-0-323-09178-7. OCLC   830669119.
  19. ↑ Lam YM, Tse HF, Lau CP (April 2001). "Continuous calcium chloride infusion for massive nifedipine overdose". Chest. 119 (4): 1280–1282. doi:10.1378/chest.119.4.1280. PMID   11296202.
  20. ↑ Ruilope LM, Oliet A, Alcázar JM, Hernández E, Andrés A, Rodicio JL, et al. (December 1989). "Characterization of the renal effects of an intravenous calcium gluconate infusion in normotensive volunteers". Journal of Hypertension Supplement. 7 (6): S170 –S171. doi:10.1097/00004872-198900076-00081. PMID   2632708.
  21. ↑ Bernardi M, Di Marco C, Trevisani F, Fornalè L, Andreone P, Cursaro C, et al. (July 1993). "Renal sodium retention during upright posture in preascitic cirrhosis". Gastroenterology. 105 (1): 188–193. doi:10.1016/0016-5085(93)90025-8. PMID   8514034.
  22. ↑ Wong F, Massie D, Colman J, Dudley F (March 1993). "Glomerular hyperfiltration in patients with well-compensated alcoholic cirrhosis". Gastroenterology. 104 (3): 884–889. doi:10.1016/0016-5085(93)91026-e. PMID   8440439.
  23. ↑ Lahera V, Fiksen-Olsen MJ, Romero JC (February 1990). "Stimulation of renin release by intrarenal calcium infusion". Hypertension. 15 (2 Suppl): I149 –I152. doi: 10.1161/01.hyp.15.2_suppl.i149 . PMID   2404858.
  24. ↑ "FDA Drug Shortages". www.accessdata.fda.gov. Archived from the original on 18 September 2017. Retrieved 21 November 2015.
  25. ↑ Pestana C (July 2015). Dr. Pestana's Surgery Notes: Top 180 Vignettes for the Surgical Wards. Simon and Schuster. ISBN   978-1-5062-0201-3.
  26. ↑ Offerman SR, Daubert GP, Clark RF (2011). "The treatment of black widow spider envenomation with antivenin latrodectus mactans: a case series". The Permanente Journal. 15 (3): 76–81. doi:10.7812/tpp/10-136. PMC   3200105 . PMID   22058673.
  27. ↑ Clark RF, Wethern-Kestner S, Vance MV, Gerkin R (July 1992). "Clinical presentation and treatment of black widow spider envenomation: a review of 163 cases". Annals of Emergency Medicine. 21 (7): 782–787. doi:10.1016/S0196-0644(05)81021-2. PMID   1351707.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.