Hypocalcemia in Emergency Medicine Medication

  • Author: Christopher B Beach, MD, FACEP, FAAEM; Chief Editor: Erik D Schraga, MD   more...
 
Updated: Feb 11, 2011
 

Medication Summary

In the ED, magnesium and calcium (in their many different forms) are the only medications necessary to treat hypocalcemic emergencies. The consulting endocrinologist may choose to prescribe any of the various vitamin D supplements depending on laboratory workup findings and oral calcium supplementation for outpatient therapy.

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Electrolyte supplements

Class Summary

These agents are used to increase blood calcium levels.

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Calcium citrate (Citracal)

 

Oral formulation usually used as supplementation to IV calcium therapy. Moderates nerve and muscle performance by regulating action potential excitation threshold and facilitating normal cardiac function. Give amount needed to supplement diet to reach recommended daily amounts. Amount of elemental calcium in calcium citrate is 200 mg.

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Calcium chloride

 

Moderates nerve and muscle performance by regulating action potential excitation threshold. Used when ventricular fibrillation is not associated with hyperkalemia, digitalis toxicity, hypercalcemia, renal insufficiency, or cardiac disease. Preferred when patient is in cardiac arrest and in other serious cases. The 10% IV solution provides 100 mg/mL of calcium chloride that equals 27.2 mg/mL (1.4 mEq/mL) of elemental calcium (10 mL of calcium chloride 10% contain 272 mg of elemental calcium).

DOC for patients in cardiac arrest.

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Calcium carbonate (Oystercal)

 

Used orally as supplementation to IV calcium therapy. Moderates nerve and muscle performance by regulating action potential excitation threshold.

Amounts of elemental calcium in calcium carbonate are as follows: Tums - 200 mg; Rolaids - 220 mg; Os-Cal - 500 mg.

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Calcium gluconate (Kalcinate)

 

Useful in treating hypocalcemia. Moderate nerve and muscle performance by regulating action potential excitation threshold.

DOC for patients not in cardiac arrest (90 mg of elemental calcium in 10 mL of 10% solution). Oral formulation usually used as supplementation to IV calcium therapy. Amounts of elemental calcium in calcium gluconate are as follows: 500-mg tablet - 45 mg; 650-mg tablet - 58.5 mg; 975-mg tablet - 87.75 mg; 1-g tablet - 90 mg.

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Contributor Information and Disclosures
Author

Christopher B Beach, MD, FACEP, FAAEM  Associate Professor and Vice Chairman of Emergency Medicine, Department of Emergency Medicine, Northwestern University, The Feinberg School of Medicine

Christopher B Beach, MD, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Robin R Hemphill, MD, MPH  Associate Professor, Director, Quality and Safety, Department of Emergency Medicine, Emory University School of Medicine

Robin R Hemphill, MD, MPH is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jeffrey L Arnold, MD, FACEP  Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center

Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physicians

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD  Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

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