Generic Name

Calcium Chloride

---

Classification

FDA Approved Indications

• Treatment of calcium deficiency
• Prevention and treatment of hypocalcemia during massive transfusions

Mechanism of Action

Supplies calcium ions, which are essential for various physiological functions including muscle contraction, nerve transmission, and blood clotting.

Dosage and Administration

Adult: Dose varies depending on the clinical situation, typically 0.5 to 1 g IV slowly over 2-5 minutes

Pediatric: Dose based on weight and clinical condition, usually 20-50 mg/kg IV slowly

Geriatric: Same as adult, with caution regarding cardiac and renal status

Renal Impairment: Adjust dose as necessary, monitor calcium levels closely

Hepatic Impairment: No specific adjustment typically required

Pharmacokinetics

Absorption: Rapid IV absorption with immediate increase in serum calcium levels

Distribution: Widely distributed in body fluids and tissues

Metabolism: Not metabolized, acts directly

Excretion: Primarily excreted by the kidneys

Half Life: Approximately 30 minutes to 2 hours

Contraindications

• Hypercalcemia
• Ventricular fibrillation

Precautions

• Use cautiously in patients with hypercalcemia, cardiac disease, or renal impairment. Watch for extravasation during IV administration.

Adverse Reactions - Common

• Arrhythmias (Uncommon)
• Injection site inflammation (Uncommon)

Adverse Reactions - Serious

• Cardiac arrest (Rare)
• Extravasation leading to tissue necrosis (Rare)

Drug-Drug Interactions

• Digoxin (can increase risk of toxicity)

Drug-Food Interactions

• No significant food interactions

Drug-Herb Interactions

• Limited data, caution with herbal supplements affecting calcium levels

Nursing Implications

Patient/Family Teaching

• Report any chest pain, arrhythmias, or unusual symptoms
• Avoid calcium-containing antacids unless advised by provider

Special Considerations

Black Box Warnings:

• IV administration may cause arrhythmias and tissue necrosis if extravasation occurs

Genetic Factors: None significant

Lab Test Interference: May interfere with certain lab tests, e.g., calcium levels in blood tests that use colorimetric methods

Overdose Management

Signs/Symptoms: Severe hypercalcemia, cardiac arrhythmias, hypotension

Treatment: Discontinue calcium, administer IV fluids, diuretics, and medications like calcitonin or bisphosphonates as needed

Storage and Handling

Storage: Room temperature, protected from light and moisture

Stability: Stable until expiration date on the label