Drug Summary

Calcium Chloride

Pharmacologic properties:

Calcium is a cation that essential for neurotransmission, bone formation, enzymatic reactions and muscle (including cardiac) contraction. In the myocardium, it increases the force of contraction and augments cardiac output. Calcium also has a stabilizing effect on myocardial membranes when dangerously high potassium levels make the heart at risk for fibrillation.

Indications:

  • Hyperkalemia with associated ECG disturbances
  • Hypocalcemia (known)
  • Calcium channel blocker toxicity with hemodynamic compromise
  • Magnesium (MgS04) toxicity

Contraindications:

  • Cardiac arrest not associated with one of the above
  • Digoxin toxicity
  • Hypercalcemia

Precautions:

  • Cautious use in patients receiving Digoxin - do not administer to patients with suspected Digoxin toxicity or overdose
  • Do not mix with sodium bicarbonate - it will precipitate

Adverse Reactions:

  • Bradycardia (usually caused by rapid administration)
  • Arrhythmias - especially in patients on digoxin
  • Sclerosis of veins (if IV infiltrates)

Dosage and administration:

  • Adult
    • 1 gram (10 ml of a 10% solution), IV bolus
    • May repeat once in ten minutes if no response
  • Pediatric
    • 0.2 ml/kg (20 mg/kg) slow IV push
    • May repeat once in 10 minutes if no response (maximum dose 2 grams)